PGY-2, Duke Medical Hospital, Department of Internal Medicine, Medical Residency Office, Durham, NC 27710, USA.
Expert Opin Pharmacother. 2013 Aug;14(11):1529-36. doi: 10.1517/14656566.2013.802307. Epub 2013 May 17.
Clostridium difficile has become the most important healthcare-associated infection worldwide within the past decade. This is in part due to the emergence of a highly virulent epidemic strain of C. difficile as well as the relative ineffectiveness of current therapies at producing a sustained response. Fidaxomicin is a novel antibiotic that demonstrates a greater sustained response for C. difficile-associated diarrhea (CDAD) compared to existing drugs and its potential role as a prophylactic agent against C. difficile infection (CDI) is being intensely studied.
In this article, we address the emergence of CDI and the current treatment options and identify the unmet needs of the marketplace. We also summarize the pharmacodynamic and pharmacokinetic properties of fidaxomicin, and review the current literature related to the use of fidaxomicin for both treatment and prophylaxis of CDI.
Fidaxomicin is clearly as effective in the treatment of CDAD as oral vancomycin. It has also been shown to reduce recurrent CDAD, and we hypothesize that the same properties that confer reduced recurrence make it a promising agent for prophylaxis, particularly in high-risk patients.
在过去十年中,艰难梭菌已成为全球最重要的与医疗保健相关的感染。这部分是由于一种高毒力的流行艰难梭菌菌株的出现,以及当前治疗方法在产生持续反应方面的相对无效性。非达霉素是一种新型抗生素,与现有药物相比,它对艰难梭菌相关性腹泻(CDAD)具有更高的持续反应,并且其作为预防艰难梭菌感染(CDI)的潜在作用正在被深入研究。
在本文中,我们探讨了 CDI 的出现以及当前的治疗选择,并确定了市场的未满足需求。我们还总结了非达霉素的药效学和药代动力学特性,并回顾了与非达霉素在治疗和预防 CDI 方面的使用相关的当前文献。
非达霉素在治疗 CDAD 方面与口服万古霉素一样有效。它也已被证明可降低复发性 CDAD,我们假设赋予降低复发的相同特性使其成为预防的有前途的药物,特别是在高危患者中。