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Emerging therapies for Clostridium difficile infection – focus on fidaxomicin

Authors Chaparro-Rojas F, Mullane KM

Received 1 March 2013

Accepted for publication 15 April 2013

Published 28 June 2013 Volume 2013:6 Pages 41—53

DOI https://doi.org/10.2147/IDR.S24434

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Fredy Chaparro-Rojas, Kathleen M Mullane

Department of Medicine, Section of Infectious Diseases, University of Chicago, Chicago, IL, USA

Abstract: The epidemiology of Clostridium difficile infections (CDI) has evolved during the last decades, with an increase in the reported incidence, severity of cases, and rate of mortality and relapses. These increases have primarily affected some special populations including the elderly, patients requiring concomitant antibiotic therapy, patients with renal failure, and patients with cancer. Until recently, the treatment of CDI was limited to either metronidazole or vancomycin. New therapeutic options have emerged to address the shortcomings of current antibiotic therapy. Fidaxomicin stands out as the first-in-class oral macrocyclic antibiotic with targeted activity against C. difficile and minimal collateral damage on the normal colonic flora. Fidaxomicin has demonstrated performance not inferior to what is considered the “gold standard” available therapy for CDI, vancomycin, in two separate Phase III clinical trials, but with significant advantages, including fewer recurrences and higher rates of sustained clinical cures. Fidaxomicin constitutes an important development in targeted antibiotic therapy for CDI and must be considered as a first-line agent for patients with risk factors known to portend relapse and severe infection.

Keywords: fidaxomicin, Clostridium difficile-associated diarrhea, CDAD, Clostridium difficile infection (CDI), vancomycin, metronidazole

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