- |||||||||| vancomycin / Generic mfg., Dificid (fidaxomicin) / Merck (MSD), Astellas, Zinplava (bezlotoxumab) / Merck (MSD)
Clinical, Review, Journal: Prevention of recurrent Clostridioides difficile infection: A systematic review of randomized controlled trials. (Pubmed Central) - Oct 3, 2020 Actoxumab (MAb against C. difficile toxin A; CDA1) plus bezlotoxumab (MAb against C. difficile toxin B; CDB1) in combination or bezlotoxumab alone appeared to be more effective in preventing rCDI compared to actoxumab alone...Several CDI-specific antibiotics, FMT modalities, monoclonal antibodies, and various prebiotics and probiotics demonstrated a reduction in risk of rCDI with the greatest risk reduction observed with FMT and monoclonal antibody therapy. It is notable that the comparators in these studies were very different from one another and the relative risk reduction of rCDI may not be directly comparable from one study to the next.
- |||||||||| tacrolimus / Generic mfg., sirolimus / Generic mfg.
[VIRTUAL] Not Your Typical Diarrhea: A Case of Disseminated MAC in a Solid Organ Transplant Recipient () - Sep 15, 2020 - Abstract #ACG2020ACG_1223; She was recently discharged after a prolonged hospital stay for management of acute diarrhea and was diagnosed with recurrent Clostridium difficile Infection (CDI) that required multiple courses of fidaxomicin as she was intolerant to vancomycin...Her immunosuppressive regimen included mycophenolic acid, sirolimus, prednisone, and tacrolimus with therapeutic range drug levels...Patient was started antimicrobial therapy with ethambutol, rifampin, and azithromycin guided by infectious disease specialist with resolution of diarrhea and weight gain...The causes of diarrhea are exhaustive in patients on immunosuppression and hence it is important to keep MAC in the differential as its diagnosis is challenging and requires tissue sampling with culture and gene sequencing. Antimicrobials provide effective treatment and eradication.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas
[VIRTUAL] Fidaxomicin Use for Clostridium difficile Infection Decreases the Effect of Coumadin in Elderly () - Sep 15, 2020 - Abstract #ACG2020ACG_1085; Alternate regimen such as the prolonged pulse taper of Vancomycin should be used for the C.diff recurrences. There is only one article about this interaction in the literature and as Gastroenterologists increase the use of this drug to treat C.Diff infection, further studies need to be done to confirm this interaction to prevent catastrophic complications in the elderly with subtherapeutic INR.
- |||||||||| vancomycin / Generic mfg., Dificid (fidaxomicin) / Merck (MSD), Astellas
Clinical, Review, Journal: Management of Clostridioides difficile infection in patients with inflammatory bowel disease. (Pubmed Central) - Aug 19, 2020 Microbiota restoration therapies are effective to prevent recurrent CDI in IBD patients. This review summarizes the epidemiology, pathophysiology, diagnostic testing, outcomes and management of both CDI and IBD, in CDI complicating IBD.
- |||||||||| Flagyl (metronidazole) / SLA, vancomycin / Generic mfg., Dificid (fidaxomicin) / Merck (MSD), Astellas
Retrospective data, Journal: Fidaxomicin compared with vancomycin and metronidazole for the treatment of Clostridioides (Clostridium) difficile infection: A network meta-analysis. (Pubmed Central) - Jun 25, 2020 For sustained cure (clinical cure without recurrence), there was a significant difference in favour of FDX versus VCM (OR: 1.61; 95% CrI: 1.27, 2.05) and MTZ (OR: 2.39; 95% CrI: 1.65, 3.47). These findings suggest that FDX and VCM are effective first-line treatments for mild or moderate CDI, whereas MTZ is not, and FDX may be more effective at preventing CDI recurrence than VCM.
- |||||||||| vancomycin / Generic mfg., Dificid (fidaxomicin) / Merck (MSD), Astellas
Clinical, Journal: Efficacy of Bezlotoxumab in Participants Receiving Metronidazole, Vancomycin, or Fidaxomicin for Treatment of Clostridioides (Clostridium) difficile Infection. (Pubmed Central) - Jun 13, 2020 P3 rCDI rates were lower in all antibiotic subgroups for bezlotoxumab vs placebo (metronidazole: rate difference [RD], -9.7%; 95% confidence interval [CI], -16.4% to -3.1%; vancomycin: RD, -15.4%; 95% CI, -22.7% to -8.0%; fidaxomicin: RD, -11.9%; 95% CI, -38.1% to 14.3%). Bezlotoxumab reduces rCDI vs placebo in participants receiving metronidazole and vancomycin, with a similar effect size in participants receiving fidaxomicin.
- |||||||||| Flagyl (metronidazole) / SLA
[VIRTUAL] An intervention bundle to improve compliance with clinical guidelines for Clostridioides difficile infection: a quasi- experimental study () - May 22, 2020 - Abstract #ECCMID2020ECCMID_5793; The intervention led to an increase in the use of oral vancomycin (50.6% [87/172] vs. 34.5% [79/231]; P-value<0.001) and fidaxomicin (3.5% [6/172] vs. 0% [0/231]; P-value<0.001) and a decrease in the use of oral metronidazole (36% [62/172] vs. 54.5% [126/231]; P-value=0.0014) and intravenous metronidazole (7.6% [13/172] vs. 23.8% [55/231]; P-value=0.005). A bundle of evidence-based measures for patients diagnosed with a first episode of CDI provided a better compliance with clinical practice guidelines and might reduce the rate of relapses.
- |||||||||| Clinical, Journal: Clostridium Difficile Infection in Patients Impact Suspected Cytomegalovirus Infection in Patients with Inflammatory Bowel Disease. (Pubmed Central) - May 16, 2020
Of the 14 IBD patients with CDI, 8 patients (57.1%) were receiving anti-tumor necrosis factor (anti-TNF) therapy (21.4 % infliximab or golimumab, 7.1% vedolizumab or adalimumab) and 43.5% of patients were being treated with systemic corticosteroids...Among them, 1 patient (7.1%) had recurrent CDI after 5 months from the first episode of CDI.These patients were treated with vancomycin, metronidazole and fidaxomicin...Immunosuppressive medications and older age are associated with increased risk of CDI and poor outcome. Although, CMV is a rare colonic pathogen in the immunocompetent patient, it should be included and screened when exacerbation of IBD occurs in patients receiving any type of immunosuppressive therapy.
- |||||||||| Flagyl (metronidazole) / SLA
Journal: Clostridioides difficile Infection: Update on Management. (Pubmed Central) - May 9, 2020 Metronidazole is no longer recommended as first-line therapy for adults...In routine or endemic settings, hands should be cleaned with either soap and water or an alcohol-based product, but during outbreaks soap and water is superior. The Infectious Diseases Society of America does not recommend the use of probiotics for prevention of C. difficile infection.
- |||||||||| Flagyl (metronidazole) / SLA
Review, Journal: Updated Management Guidelines for Clostridioides difficile in Paediatrics. (Pubmed Central) - Apr 23, 2020 Fidaxomicin is a new treatment option with equivalent initial response rates as vancomycin but lower relapse rates of CDI...Monoclonal antibodies and vaccines seem to represent a future perspective against CDI. However, only further studies will permit us to understand whether these new approaches could be effective in therapy and prevention of CDI in paediatric populations.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas, NN1213 / Novo Nordisk
Enrollment closed: OpTION: Optimal Treatment for Recurrent Clostridium Difficile (clinicaltrials.gov) - Apr 7, 2020 P4, N=546, Active, not recruiting, Whether co-existence of the two above-mentioned distinct clinical entities is just a co-incidence or CDI is a triggering factor for IgA vasculitis remains to be elucidated in future large-scale studies. Recruiting --> Active, not recruiting
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