Novotný Martin, Jarčuška Pavol, Gombošová Laura, Hockicko Ján, Hockicková Ivana, Rovňáková Alena, Zahornacký Ondrej, Schréter Ivan, Dorko Erik, Rimárová Kvetoslava
Department of Infectology and Travel Medicine, Faculty of Medicine, Pavol Jozef Safarik University in Kosice and Louis Pasteur University Hospital, Kosice, Slovak Republic.
1st Department of Internal Medicine, Faculty of Medicine, Pavol Jozef Safarik University in Kosice and Louis Pasteur University Hospital, Kosice, Slovak Republic.
Cent Eur J Public Health. 2018 Dec;26 Suppl:S76-S80. doi: 10.21101/cejph.a5476.
Clostridium difficile infection (CDI) has become one of the most common causes of hospital-acquired infections. Fidaxomicin is one of the latest antibiotics used in the treatment of CDI, however, treatment cost affects recommendations for its use in several countries. We have analysed the treatment of our patients with CDI, treated by fidaxomicin since it was introduced to the market in 2018 and became available in the second biggest Slovak hospital, University Hospital of L. Pasteur. Our aim was to determine efficacy and safety of fidaxomicin in the treatment of CDI in Slovak patients.
We reviewed all courses of fidaxomicin use in our hospital (n = 60). Fidaxomicin was used for first recurrence (12 times), second recurrence (4 times), third recurrence (2 times), and fifth recurrence (1 patient). 41 patients received fidaxomicin first-line.
Success of fidaxomicin treatment was recorded at 86.7% within the whole cohort. In the recurrent Clostridium difficile infection (rCDI) subgroup, fidaxomicin was 63% effective with three patients dying (15.7%) and two patients developing subsequent rCDI. During the duration of the study, 6 patients in total died. Only one of three patients, with three or more recurrences of CDI, had no further presentations after eight weeks of completion of treatment.
The biggest benefit from fidaxomicin treatment was shown in a cohort of patients with primary CDI infection demonstrating a low recurrence rate and significant reduction of fidaxomicin effectiveness in preventing a recurrence when treating patients with multiple rCDI.
艰难梭菌感染（CDI）已成为医院获得性感染最常见的原因之一。非达霉素是用于治疗CDI的最新抗生素之一，然而，治疗成本影响了其在多个国家的使用推荐。我们分析了自2018年非达霉素上市并在斯洛伐克第二大医院——L. 巴斯德大学医院可供使用以来，我院使用该药物治疗CDI患者的情况。我们的目的是确定非达霉素治疗斯洛伐克CDI患者的疗效和安全性。
我们回顾了我院使用非达霉素的所有疗程（n = 60）。非达霉素用于首次复发（12次）、第二次复发（4次）、第三次复发（2次）以及第五次复发（1例患者）。41例患者一线使用非达霉素。
在整个队列中，非达霉素治疗成功率记录为86.7%。在复发性艰难梭菌感染（rCDI）亚组中，非达霉素的有效率为63%，3例患者死亡（15.7%），2例患者随后发生rCDI。在研究期间，共有6例患者死亡。在CDI复发三次或更多次的3例患者中，只有1例在完成治疗8周后未再出现症状。
非达霉素治疗的最大益处体现在原发性CDI感染患者队列中，复发率较低，而在治疗多次rCDI患者时，非达霉素预防复发的有效性显著降低。
