Is oral fidaxomicin effective in the treatment of Clostridium difficile (C diff) colitis?

Updated: Jul 25, 2019
  • Author: Faten N Aberra, MD, MSCE; Chief Editor: BS Anand, MD  more...
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In several clinical trials, 200 mg of oral fidaxomicin administered every 12 hours for 10 days was found to be noninferior to 125 mg of oral vancomycin administered every 6 hours for 10 days for the treatment of C difficile. [57] There was no difference in cure rates based on C difficile disease severity. Symptomatic improvement is generally expected within 2-3 days.

In a multicenter retrospective (2013-2014) study of CDI in 72 Spanish patients, fidaxomicin treatment was effective and well tolerated in patients with severe CDI as well as those at high risk of recurrent disease. [58] The clinical cure rate was 90.3%, with a 16.7% recurrence rate and a 72.2% sustained cure rate. The investigators found that factors that adversely affected the sustained cure rate included the presence of cardiovascular disease, acute renal failure, and systemic antibiotic treatment, as well as the C-reactive protein level measured at the time of the diagnosis. [58]

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