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Medline ® Abstract for Reference 68

of 'Clostridium difficile in adults: Treatment'

68
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Novel Fidaxomicin Treatment Regimens for Patients With Multiple Clostridium difficile Infection Recurrences That Are Refractory to Standard Therapies.
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Soriano MM, Danziger LH, Gerding DN, Johnson S
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Open Forum Infect Dis. 2014;1(2):ofu069. Epub 2014 Aug 25.
 
Reports of fidaxomicin treatment for patients with multiple recurrent Clostridium difficile infections ([mrCDI]ie, more than 2 CDI episodes) indicate symptomatic response to this agent, but 50% have subsequent mrCDI episodes. In an effort to improve outcomes in patients with mrCDI we used novel regimens of fidaxomicin based on strategies used with vancomycin. Of 8 patients who received a 10-day chaser of fidaxomicin given twice daily after a course of vancomycin, 3 (38%) experienced a subsequent recurrence. Two (18%) of 11 patients who completed a 14- to 33-day course of fidaxomicin in a tapering dose experienced a recurrence, both of whom received additional antibiotics before that recurrence. The median symptom-free interval (SFI) after fidaxomicin taper was greater than the median SFI after the most effective prior regimen for those patients (257 days [interquartile range, 280]vs 25 days [interquartile range, 30], respectively; P = .003). A fidaxomicin chaser or taper regimen may be effective in patients with mrCDI, but the number of patients treated is small, and randomized comparative data are not available.
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University of Illinois at Chicago College of Pharmacy ; Presence Resurrection Medical Center , Chicago, Illinois.
PMID