Single centre clinical experience with fidaxomicin in the treatment of Clostridium difficile infection in Slovakia.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
['Novotný|Martin|M|', 'Jarčuška|Pavol|P|', 'Gombošová|Laura|L|', 'Hockicko|Ján|J|', 'Hockicková|Ivana|I|', 'Rovňáková|Alena|A|', 'Zahornacký|Ondrej|O|', 'Schréter|Ivan|I|', 'Dorko|Erik|E|', 'Rimárová|Kvetoslava|K|']
D000293:Adolescent D000328:Adult D000368:Aged D000900:Anti-Bacterial Agents D002648:Child D016360:Clostridioides difficile D003015:Clostridium Infections D000077732:Fidaxomicin D006801:Humans D008875:Middle Aged D018154:Slovakia D016896:Treatment Outcome D055815:Young Adult
Clostridium difficile infection recurrence fidaxomicin treatment