antibioticsbooks

146 PART 2 Antibacterial Drugs
associated with C. difficile infection, including nausea,
diarrhea, abdominal pain, and cramping. More
experience is needed to further classify the adverse
reactions with fidaxomicin.
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Important Facts
• In a clinical trial comparing it with vancomycin
capsules, fidaxomicin showed similar clinical
efficacy to oral vancomycin. However, it was
superior in preventing recurrences of C. difficile
infection and may be preferred for patients at
high risk of recurrence.
• The advantages of fidaxomicin in sparing the
normal flora of the GI tract are likely negated
when it is co-administered with oral vancomycin
or metronidazole. Two drugs are not always
better than one, and these combinations should
probably be avoided.
• Currently, fidaxomicin is expensive. Patient
assistance programs are available to help
acquire the drug for those who need it.
What It’s Good For
Clostridium difficile infections, ranging from diarrhea
to pseudomembranous colitis.
Don’t Forget!
Fidaxomicin has an important benefit in lowering
C. difficile infection recurrence, but its cost necessitates
careful determination of which patients are
most likely to benefit from it.