Fidaxomicin versus metronidazole, vancomycin and their combination for initial episode, first recurrence and severe Clostridioides difficile infection - An observational cohort study
Jazyk angličtina Země Kanada Médium print-electronic
Typ dokumentu časopisecké články, pozorovací studie
PubMed
33188906
DOI
10.1016/j.ijid.2020.11.004
PII: S1201-9712(20)32315-8
Knihovny.cz E-zdroje
- Klíčová slova
- Clostridioides difficile, Fidaxomicin, Metronidazole, Recurrence, Sustained clinical response, Vancomycin,
- MeSH
- antibakteriální látky farmakologie MeSH
- aplikace orální MeSH
- Clostridioides difficile účinky léků MeSH
- fidaxomicin farmakologie MeSH
- hospitalizace MeSH
- klostridiové infekce farmakoterapie mikrobiologie MeSH
- kohortové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- logistické modely MeSH
- metronidazol farmakologie MeSH
- recidiva MeSH
- senioři MeSH
- vankomycin farmakologie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- Názvy látek
- antibakteriální látky MeSH
- fidaxomicin MeSH
- metronidazol MeSH
- vankomycin MeSH
PURPOSE: We aimed to evaluate the efficacy of different antibiotic regimens for the treatment of Clostridioides difficile infection (CDI) with regard to the CDI episode number and disease severity. METHODS: An observation cohort study included 271 CDI patients hospitalised between 2013-2016. Univariate logistic regression was used to evaluate the association between patients' clinical outcome (sustained clinical cure or recurrence) in a 60-day follow-up and the antibiotic regimen used (oral metronidazole, oral vancomycin, combination of oral vancomycin and metronidazole, oral fidaxomicin). Subgroup analyses, based on CDI episode number and severity, were performed. RESULTS: In the overall population, fidaxomicin was superior to metronidazole, vancomycin or their combination, for a sustained clinical response and in the prevention of recurrent CDI (rCDI). In the subgroup analyses, fidaxomicin was superior to vancomycin or metronidazole for a sustained clinical response and in the prevention of rCDI in the initial episode, first recurrence and non-severe cases. In the oral treatment of severe CDI, fidaxomicin had a similar treatment outcome to vancomycin and none of the antibiotic treatments were superior in the prevention of rCDI. Fidaxomicin, vancomycin, or a combination of metronidazole and vancomycin, had similar outcomes for sustained clinical response and prevention of rCDI in patients with multiple rCDI. CONCLUSION: Fidaxomicin was superior to metronidazole or vancomycin for the treatment of the initial episode, first recurrence, and non-severe CDI.
Bioinformatics Centre Charles University 2nd Faculty of Medicine Prague Czech Republic
Department of Clinical Microbiology Na Bulovce Teaching Hospital Prague Czech Republic
Citace poskytuje Crossref.org
