A slow but consistent increase in fidaxomicin use has been seen over time for the treatment of Clostridium difficile infection, mostly in combination with other systemic antibiotics, study authors reported in Springer Plus.
Fidaxomicin use has mainly been based on single-center observational studies. Study authors conducted a pharmacoepidemiology study to evaluate outcomes of patients given fidaxomicin based on episode number and use of concomitant antibiotics across hospitals in the United States. They obtained data from a large inpatient drug utilization database to assess fidaxomicin use over time. The team also conducted a multicenter retrospective chart review of hospitalized patients with Clostridium difficile infection (CDI) that received fidaxomicin between 2011–2013.
Overall, the rate of fidaxomicin use was 2.16%, an increase from 0.22% in the last two quarters of 2011 to 3.16% in the first two quarters of 2013. The multicenter study identified a total of 102 hospitalized patients that received fidaxomicin; 69 patients received fidaxomicin for early episodes (1st or 2nd episode) and 33 received for later episodes. Also, non-CDI antibiotics were administered to 48 patients. Rates of clinical outcomes were also found to be similar despite CDI episode.
Study authors added that antimicrobial stewardship teams should “provide guidance on appropriate use of fidaxomicin to optimize therapy and assess the need to continue other antibiotics during CDI treatment.”
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