- |||||||||| vancomycin / Generic mfg., Dificid (fidaxomicin) / Merck (MSD), Astellas
Clinical, Journal: Prevention of Clostridium difficile Infection in Critically Ill Adults. (Pubmed Central) - Apr 4, 2020
The preventive roles of deprescribing acid suppressants, routine use of probiotics, or early fecal microbiota transplantation remain unclear. The focus of this review is to summarize the evidence related to primary and secondary CDI prevention in critically ill adults and provide a concise implementation pathway for clinicians and policy makers.
- |||||||||| Remicade (infliximab) / Mitsubishi Tanabe, J&J, Flagyl (metronidazole) / SLA
Clinical, Journal: Clostridium difficile infection in Inflammatory Bowel Disease Patients. (Pubmed Central) - Mar 31, 2020
The focus of this review is to summarize the evidence related to primary and secondary CDI prevention in critically ill adults and provide a concise implementation pathway for clinicians and policy makers. Although the use of infliximab during CDI has been debated, clinical experience exists supporting its use in an IBD flare, even with active CDI when needed.
- |||||||||| Flagyl (metronidazole) / SLA
Perhaps Passive Immunity isn't as Passive as We Think () - Mar 27, 2020 - Abstract #NKFCSM2020NKF_CSM_141;
Management of severe refractory CDI in SOT recipients represents a therapeutic challenge. Use of IVIG along with standard therapy should be considered for these patients with limited treatment options
- |||||||||| Flagyl (metronidazole) / SLA, Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA
[VIRTUAL] ASSESSING THE REAL-WORLD INPATIENT TREATMENT PARADIGM FOR RECURRENT CLOSTRIDIUM DIFFICILE () - Mar 8, 2020 - Abstract #ISPOR2020ISPOR_1975;
CONCLUSIONS : The real-world treatment of inpatients experiencing rCDI aligned only moderately with published guidelines, with higher use of metronidazole and lower use of fidaxomicin than might be expected per these recommendations. While current approaches to treatment rely heavily on the effectiveness of vancomycin, the rate of rCDI is increasing, suggesting the need for a more effective alternative and stronger evidence to define the optimal treatment regimen.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas, Zinplava (bezlotoxumab) / Merck (MSD)
[VIRTUAL] COST-EFFECTIVENESS OF BEZLOTOXUMAB AND FIDAXOMICIN FOR RECURRENT C. DIFFICILE INFECTION () - Mar 8, 2020 - Abstract #ISPOR2020ISPOR_1940;
CONCLUSIONS : Based on a WTP threshold of $150,000, fidaxomicin was estimated to be the most cost-effective therapy for treating an episode of CDI and preventing further recurrence. The addition of bezlotoxumab to vancomycin was estimated to be not cost-effective for initial and recurrent CDI compared to either fidaxomicin or vancomycin alone.
- |||||||||| Flagyl (metronidazole) / SLA
Journal: Prevention and treatment of Clostridium difficile associated diarrhea by reconstitution of the microbiota. (Pubmed Central) - Mar 3, 2020
New therapies focus on limiting further destruction of the gut microbiota or restoring the microbiota to its pre-destructed state. These include new antibiotics, such as fidaxomicin, which demonstrates reduced CDI recurrences, among other new drugs, biotherapeutic strategies, mainly fecal microbiota transplantation but also competitive inhibition with non-toxigenic strains of C. difficile, and finally, monoclonal antibodies against C. difficile toxins which offer protection against recurrences.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas
Clinical, Journal: Initial experience of fecal microbiota transplantation in gastrointestinal disease: A case series. (Pubmed Central) - Feb 14, 2020
FMT is considered to be a well-tolerated adjuvant treatment for UC and effective salvage treatment for rCDI in our initial experience. Multiple infusions of FMT in UC and rCDI might have exceptional clinical efficiency, and enteral tube insertion could be a useful method to reach this goal and make multiple sessions of FMT easier.
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA
Clinical, Review, Journal: Doctor, my patient has CDI and should continue to receive antibiotics. The (unresolved) risk of recurrent CDI. (Pubmed Central) - Feb 14, 2020
In recent years, promising new strategies have emerged for effective prevention of recurrent CDI (rCDI) including new an-timicrobials (eg, fidaxomicin) and monoclonal antibodies (eg, bezlotoxumab)...This positioning review describes the current epidemiology of rCDI, its clinical impact and risk factors, some of the measures used for treating and preventing rCDI, and some of the emerging treatment options. It then describes some of the barriers that need to be overcome.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas
[VIRTUAL] RISK FACTORS AND OUTCOME OF EARLY CLOSTRIDIUM DIFFICILE INFECTION IN ACUTE LEUKEMIA PATIENTS UNDERGOING ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION (ePoster Area) - Feb 8, 2020 - Abstract #EBMT2020EBMT_1508;
We conclude that in our experience risk of early CDI infection after HSCT was increased by pre-trasplant factors such as previous gram negative bacterial infections and prior abdominal surgery and by the choice of mismatched unrelated donor. Stool negativity was obtained in all patients with appropriate treatment and there was no increased risk of GvHD or OS impairment, suggesting that search for CDI at the first episode of diarrhea after HSCT and prompt treatment can definitively solve this infection without sequelae in allogeneic HSCT recipients.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas
Journal: FadR1, a pathway-specific activator of fidaxomicin biosynthesis in Actinoplanes deccanensis Yp-1. (Pubmed Central) - Dec 19, 2019
All results indicated that fadR1 encodes a pathway-specific positive regulator of fidaxomicin biosynthesis and upregulates the transcription levels of most of genes by binding to the four above intergenic regions. In summary, we not only clearly elucidate the regulatory mechanism of FadR1 but also provide strategies for the construction of industrial high-yield strain of fidaxomicin.
- |||||||||| Flagyl (metronidazole) / SLA, ciprofloxacin / Generic Mfg., meropenem / Generic Mfg., Daewon Pharmaceutical
Journal: The first isolation of Clostridium difficile RT078/ST11 from pigs in China. (Pubmed Central) - Nov 27, 2019
This is the first report of the molecular epidemiology of C. difficile isolated from food animals in China. We identified the epidemic strain RT078/ST11 as the predominate isolate among the animals we screened in our study.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas
Review, Journal: Treatment of Severe and Fulminnant Clostridioides difficile Infection. (Pubmed Central) - Nov 21, 2019
A patient population likely to benefit the most from FMT is elderly patients due to their increased risk for CDI, treatment failure, and high comorbidity burden that may preclude surgical intervention. FMT should be considered in patients with SCDI or FCDI particularly when traditional anti-CDI antibiotics are ineffective.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas
Preclinical, Journal: Novel In Vitro Method Reveals Drugs that Inhibit Solute Transporter Alpha/Beta (OSTα/β). (Pubmed Central) - Nov 21, 2019
This study utilized a novel in vitro method to identify OSTα/β inhibitors, and for the first time, provided IC50 values for OSTα/β inhibition. These data provide evidence that several drugs, some of which are associated with cholestatic drug-induced liver injury, may impair the function of the OSTα/β transporter.
- |||||||||| Flagyl (metronidazole) / SLA
Review, Journal: Clostridium difficile infection: review. (Pubmed Central) - Nov 19, 2019
Antibiotics of choice are vancomycin, fidaxomicin, and metronidazole, though metronidazole is considered as inferior. The goal of this review is to update physicians on current scientific knowledge of C. difficile infection, focusing also on fecal microbiota transplantation which is a promising therapy.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas
Reconstruction of Human AML Reveals Stem Cell Origin and Therapeutic Targets for Treatment Resistant CD34-/Lo MLL-Rearranged Leukemia (Hall B, Level 2 (Orange County Convention Center)) - Nov 7, 2019 - Abstract #ASH2019ASH_4399;
Strikingly, shRNA-mediated knockdown or pharmacological inhibition by fidaxomicin targeting ATP-binding cassette (ABC) transporters, ABCC3 that is highly expressed in HSCs-derived MLL-AML could re-sensitize the cells to the current chemotherapy . Together, the current study not only for the first time functionally identifies the origin of human MLL-AML stem cells, but also provides a new actionable venue for overcoming stem cells-associated treatment resistance by repositioning an anti-diarrhea drug, fidaxomicin currently available in the clinics.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas, warfarin / Generic Mfg., Eliquis (apixaban) / BMS
Clinical, Review, Journal: Hospital Medicine Update: High-Impact Literature from March 2018 to April 2019. (Pubmed Central) - Oct 22, 2019
The authors voted to select 10 of 30 presented articles based on quality and clinical impact for this summary. The key findings include: (1) Vancomycin or fidaxomicin are the first-line treatment for initial Clostridioides difficile infection; (2) Unnecessary supplemental oxygen is linked to increased mortality; aim for a target oxygen saturation of 90%-94% in most hospitalized patients; (3) Stigmatizing language in medical records impacts physician trainees' attitudes and pain management practices; (4) Consider ablation for atrial fibrillation in patients with heart failure; (5) Patients with opioid use disorder should be offered buprenorphine or methadone therapy; (6) Apixaban is safe and may be preferable over warfarin in patients with atrial fibrillation and end-stage kidney disease; (7) It is probably safe to discontinue antimethicillin-resistant Staphylococcus aureus (MRSA) coverage in patients with hospital-acquired pneumonia who are improving and have negative cultures; (8) Selected patients with left-sided endocarditis (excluding MRSA) may switch from intravenous (IV) to oral antibiotics if they are clinically stable after 10 days; (9) Oral antibiotics may be equivalent to IV antibiotics in patients with joint and soft tissue infections; (10) A history-electrocardiogram-age-risk factors-troponin (HEART) score ≥4 is a reliable threshold for determining the patients who are at risk for short-term major adverse cardiac events and may warrant further evaluation.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas, NN1213 / Novo Nordisk
Trial completion, Trial completion date, Trial primary completion date: FACIT: Fecal Microbiota Transplantation for Relapsing Clostridium Difficile Infection (clinicaltrials.gov) - Oct 15, 2019
P3, N=64, Completed,
Incidence of TEAEs was similar to previous Phase III trials, suggesting that fidaxomicin is comparatively well tolerated in patients with IBD. Active, not recruiting --> Completed | Trial completion date: Apr 2019 --> Aug 2019 | Trial primary completion date: Aug 2018 --> Feb 2019
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas
Phase classification: C-Diff: Impact of Oral Antibiotic Treatment on C. Difficile (clinicaltrials.gov) - Oct 2, 2019
P4, N=33, Completed,
Active, not recruiting --> Completed | Trial completion date: Apr 2019 --> Aug 2019 | Trial primary completion date: Aug 2018 --> Feb 2019 Phase classification: P=N/A --> P4
- |||||||||| Flagyl (metronidazole) / SLA
Review, Journal: Treatment of acute and recurrent Clostridium difficile infections : What is new? (Pubmed Central) - Sep 14, 2019
In recent years, several new antibiotics with narrow-spectrum acitivity and low intestinal resorption have been developed for the treatment of CDI, including surotomycin, cadazolid, and ridinilazol. Novel toxoid vaccines are expected to become an efficacious tool in the prevention of CDI; however, pivotal clinical trials have so far not been completed.
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