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Partial Courses of Fidaxomicin Followed by Oral Vancomycin and the Effect on Recurrence of Clostridioides difficile Infections

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Title: Partial Courses of Fidaxomicin Followed by Oral Vancomycin and the Effect on Recurrence of Clostridioides difficile Infections
Authors: Papamanolis, Irene-Constantina, Stornelli, Nicholas, Everson, Nathan, Ahmad, Zayd, Kamrada, Meghan, Lockhart, Ellen R, McDaniel, Lauren
Source: Pharmacy Articles
Publisher Information: Henry Ford Health Scholarly Commons
Publication Year: 2025
Collection: Henry Ford Health System Scholarly Commons
Subject Terms: Humans, Fidaxomicin, Vancomycin/administration & dosage/therapeutic use, Clostridium Infections/drug therapy/prevention & control, Retrospective Studies, Male, Female, Aged, Anti-Bacterial Agents/administration & dosage/therapeutic use, Administration, Oral, Middle Aged, Clostridioides difficile, Aminoglycosides/administration & dosage/therapeutic use, Recurrence, Cohort Studies, 80 and over, Treatment Outcome, antimicrobial stewardship, vancomycin
Description: BACKGROUND: Clostridioides difficile infection (CDI) causes a significant national health care burden. Literature has demonstrated lower rates of CDI recurrence with fidaxomicin compared with oral vancomycin. However, patients are sometimes switched to oral vancomycin before completing a fidaxomicin course. OBJECTIVE: The objective of this study is to evaluate rates of CDI recurrence in full courses of fidaxomicin versus partial courses of fidaxomicin followed by a switch to oral vancomycin. METHODS: In this single-center, retrospective, cohort study of adults with CDI, patients were screened for inclusion if they received either a full 10-day course of fidaxomicin or partial course of fidaxomicin followed by a switch to oral vancomycin. The primary outcome was the rate of CDI recurrence within 30 days after completion of initial therapy determined by a positive CDI test and initiation of treatment. RESULTS: Ninety-nine patients received a full course of fidaxomicin, and 95 patients received a partial course of fidaxomicin followed by oral vancomycin. Mean age was lower in the full course group compared with the partial course (65.3 years vs 71.5 years, P < 0.002). Clostridioides difficile infection recurrence occurred in 5.1% of the full course group and 7.4% of the partial therapy group (P = 0.503) at 30 days and 13.1% versus 14.7% (P = 0.747) at 90 days. Clostridioides difficile infection-related readmissions at 30 days were similar in the full course and partial course groups (7.1% vs 4.2%, P = 0.389). CONCLUSION AND RELEVANCE: Partial courses of fidaxomicin followed by oral vancomycin had similar 30-day CDI recurrence compared with full course fidaxomicin.
Document Type: text
Language: unknown
Relation: https://scholarlycommons.henryford.com/pharmacy_articles/233; https://libkey.io/libraries/106/gotofulltext/pmid/40326081
Availability: https://scholarlycommons.henryford.com/pharmacy_articles/233
https://libkey.io/libraries/106/gotofulltext/pmid/40326081
Accession Number: edsbas.2A1DFFD6
Database: BASE
Description
Abstract:BACKGROUND: Clostridioides difficile infection (CDI) causes a significant national health care burden. Literature has demonstrated lower rates of CDI recurrence with fidaxomicin compared with oral vancomycin. However, patients are sometimes switched to oral vancomycin before completing a fidaxomicin course. OBJECTIVE: The objective of this study is to evaluate rates of CDI recurrence in full courses of fidaxomicin versus partial courses of fidaxomicin followed by a switch to oral vancomycin. METHODS: In this single-center, retrospective, cohort study of adults with CDI, patients were screened for inclusion if they received either a full 10-day course of fidaxomicin or partial course of fidaxomicin followed by a switch to oral vancomycin. The primary outcome was the rate of CDI recurrence within 30 days after completion of initial therapy determined by a positive CDI test and initiation of treatment. RESULTS: Ninety-nine patients received a full course of fidaxomicin, and 95 patients received a partial course of fidaxomicin followed by oral vancomycin. Mean age was lower in the full course group compared with the partial course (65.3 years vs 71.5 years, P < 0.002). Clostridioides difficile infection recurrence occurred in 5.1% of the full course group and 7.4% of the partial therapy group (P = 0.503) at 30 days and 13.1% versus 14.7% (P = 0.747) at 90 days. Clostridioides difficile infection-related readmissions at 30 days were similar in the full course and partial course groups (7.1% vs 4.2%, P = 0.389). CONCLUSION AND RELEVANCE: Partial courses of fidaxomicin followed by oral vancomycin had similar 30-day CDI recurrence compared with full course fidaxomicin.