- |||||||||| CAR T-Cell Therapy-Induced Pseudomembranous Colitis Mimicking C. difficile Infection (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_758;
Only two prior cases of colitis after CAR T have been reported, both presenting with diarrhea like this case but differing in endoscopic findings and implicated CAR T agents (tisagenlecleucel and axicabtagene ciloleucel)...This marks the 3 rd reported case of CAR T-associated colitis, the 1 st linked to ciltacabtagene autoleucel, and highlights the importance of considering CAR T in the differential diagnosis for diarrhea...Figure: Figure A: Colonoscopy findings showing erythematous and pseudomembrane-covered mucosa in the transverse colon. Figure B: Histopathological examination of transverse colon mucosal biopsy (photomicrograph at 20x magnification, H&E stain) showing colonic mucosa with a focal area of ballooned crypts lacking.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas
Antimicrobial Resistance in Clostridioides difficile : Is It on the Rise? (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_702;
The most common resistance genes detected in both adult and pediatric isolates were the genetic mutation markers erm(B), ant(6)-la, and tet(M) which encode resistance to the non-CDI antibiotics clindamycin, streptomycin B, and tetracyclines, respectively (Figure 1). Our results suggest that WGS could be a useful tool to understand the prevalence of resistance genes in colonized or infected patients and to track the emergence of resistance.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas
Clinical, Retrospective data, Review, Journal: Efficacy of fidaxomicin versus vancomycin in the treatment of Clostridium difficile infection: A systematic meta-analysis. (Pubmed Central) - Aug 9, 2024
However, there was a high mortality rate in patients ?80 There were no significant differences between fidaxomicin and vancomycin in the treatment of CDI in therapeutic effectiveness and adverse reactions, while fidaxomicin was superior to vancomycin in terms of recurrence rate and long-term mortality, and vancomycin is more effective in treating severe CDI.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas
USE OF INTRAVENOUS IMMUNOGLOBULIN FOR SEVERE RELAPSING CLOSTRIDIUM DIFFICILE PSEUDOMEMBRANOUS COLITIS (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1286;
While conventional treatments often suffice, some cases may necessitate unconventional approaches like IVIG, as demonstrated here. Further research is warranted to elucidate the role of IVIG in such cases and to refine treatment strategies for challenging C. difficile infections.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas, RT002 / Retrotope
Journal: Antimicrobial susceptibility in Clostridioides difficile varies according to European region and isolate source. (Pubmed Central) - Jul 24, 2024
Metronidazole, vancomycin, fidaxomicin, moxifloxacin, clindamycin, imipenem, tigecycline, linezolid, rifampicin and meropenem minimum inhibitory concentrations (MICs) for 280 clinical and 126 animal isolates were determined by Wilkins-Chalgren agar dilution...Five isolates (RT002, RT010 and RT016) were metronidazole resistant (MIC?=?8 mg/L) and 10 (RT027; RT198) had intermediate resistance (4 mg/L)...No resistance to imipenem or meropenem was observed. Increased antimicrobial resistance was detected in eastern Europe and mostly associated with RT027 and related emerging RT181, while clinical isolates from northern and western Europe had the lowest general levels of resistance.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas
179 - Clinical Controversies (Concourse 152) - Jul 15, 2024 - Abstract #IDWeek2024IDWEEK_425;
Our analysis confirms current changes in guidelines, as it supports the superiority of vancomycin compared to metronidazole across all severity levels. Learning Objectives: At the conclusion of this session, participants will be able to: investigate the evidence for use of fidaxomicin; explain the use of bezlotuxumab; describe the implications of hospital onset bacteremia and preventability; advise decisions on pay for performance measures.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas, Zinplava (bezlotoxumab) / Merck (MSD)
Review, Journal: Management of Clostridioides difficile infection: Diagnosis, Treatment, and Future Perspectives. (Pubmed Central) - Jun 28, 2024
Effective infection management requires appropriate interpretation of diagnostic tests, as well as the use of vancomycin and fidaxomicin as first-line treatment. Novel treatments as Bezlotoxumab, fecal microbiota transplant and live biotherapeutic products are proven effective in recurrent C. difficile infection and addresses dysbiosis.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas, Multaq (dronedarone) / Sanofi
Journal: Exploring novel microbial metabolites and drugs for inhibiting Clostridioides difficile. (Pubmed Central) - Jun 28, 2024
Novel treatments as Bezlotoxumab, fecal microbiota transplant and live biotherapeutic products are proven effective in recurrent C. difficile infection and addresses dysbiosis. These potent agents included ecteinascidin 770 (minimum inhibitory concentration against 50% of isolates [MIC50] ?0.06
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas
Journal: Formal Single Atom Editing of the Glycosylated Natural Product Fidaxomicin Improves Acid Stability and Retains Antibiotic Activity. (Pubmed Central) - Jun 28, 2024
Using our newly established approach, Fdx was converted to the single atom exchanged analogue S-Fdx, in which the acid labile O-glycosidic bond to the noviose sugar was replaced by the acid stable S-glycosidic bond. Studies of the antibacterial activity of a structurally diverse set of thioglycoside derivatives revealed high potency of acyl derivatives of S-Fdx against Clostridioides difficile (MIC range: 0.12-4 ?g/mL) and excellent potency against Clostridium perfringens (MIC range: 0.06-0.5 ?g/mL).
- |||||||||| Review, Journal: Fighting against Clostridioides difficile infection: Current medications. (Pubmed Central) - Jun 17, 2024
Currently, researchers are investigating therapeutic antibacterial drugs (e.g., teicoplanin, ridinilazole, ibezapolstat, surotomycin, cadazolid, and LFF571), preventive medications against recurrence (e.g., Rebyota, Vowst, VP20621, VE303, RBX7455, and MET-2), primary prevention strategies (e.g., vaccine, ribaxamase, and DAV132) and other anti-CDI medications in the preclinical stage (e.g., Raja 42, Myxopyronin B, and bacteriophage). This narrative review summarizes current medications, including newly marketed drugs and products in development against CDI, to help clinicians treat CDI appropriately and to call for more research on innovation.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas
Journal: Scutellaria baicalensis Georgi alleviates Clostridium difficile associated diarrhea and its modulatory effects on the gut microbiota. (Pubmed Central) - Jun 16, 2024
Using a CDAD mouse model and fidaxomicin as a control, SR's impact was measured through diarrhea symptoms, colonic histopathology, and C. difficile toxin levels...proportions, and modulated specific bacterial species' abundance. In essence, SR effectively mitigates CDAD symptoms, curtails inflammatory reactions, and beneficially restructures gut microbiota, suggesting its potential in advanced CDAD clinical intervention.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas
Enrollment change, Trial withdrawal: Evaluation of Fidaxomicin in the Treatment of Clostridium Difficile Infection (CDI) (clinicaltrials.gov) - May 20, 2024
P=N/A, N=0, Withdrawn,
In the treatment of CDI, we showed that real-world use of fidaxomicin is associated with lower risk of a composite endpoint of treatment failure. N=50 --> 0 | Enrolling by invitation --> Withdrawn
- |||||||||| Review, Journal: Clostridioides Difficile: A Concise Review of Best Practices and Updates. (Pubmed Central) - May 10, 2024
In 2021, the Infectious Diseases Society of America/Society for Healthcare Epidemiology of America (IDSA/SHEA) shifted its preference for initial treatment to fidaxomicin over vancomycin and metronidazole due to its lower recurrence rate...There are new developments on the frontiers of fecal microbiota therapies, with RBX2660 and SER-109 approved recently by the FDA for prevention, with other microbiome-based therapies in various development and clinical trials. This review offers providers an updated and practical guide for CDI management.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas, Zinplava (bezlotoxumab) / Merck (MSD)
Review, Journal: Clostridioides difficile Colitis. (Pubmed Central) - Apr 28, 2024
Fulminant disease is treated with maximal medical therapy and early surgical consultation. Antibiotic stewardship is critical to preventing C difficile colitis.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas, Zinplava (bezlotoxumab) / Merck (MSD)
Review, Journal: New treatment approaches for Clostridioides difficile infections: alternatives to antibiotics and fecal microbiota transplantation. (Pubmed Central) - Apr 13, 2024
Antibiotics, such as vancomycin and fidaxomicin, are still the drugs of choice for C. difficile infections, but their effectiveness is limited, and microbial interventions are emerging as a new treatment option...Of these, the monoclonal antibody bezlotoxumab is already in clinical use...Small-molecule agents without bacteriolytic activity are usually selected by drug repurposing and can act via a variety of mechanisms. The multiple treatment options described in this article provide optimism for the future treatment of C. difficile infection.
- |||||||||| Review, Journal: Clostridioides difficile infection: a changing treatment paradigm. (Pubmed Central) - Apr 4, 2024
The horizon of CDI treatment also features promising therapies such as SER-109 and Rebyota, epitomising the evolving paradigm. As CDI management advances, the critical role of standardised microbiome restoration therapies becomes evident, ensuring long-term safety and diversifying treatment strategies.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas, Rebyota (fecal microbiota, live-jslm) / Ferring
Review, Journal: The epidemiology and management of Clostridioides difficile infection-A clinical update. (Pubmed Central) - Mar 27, 2024
As CDI management advances, the critical role of standardised microbiome restoration therapies becomes evident, ensuring long-term safety and diversifying treatment strategies. Although the prevalence of C. difficile infection remains high, there have been significant advances in the development of novel therapeutics and preventative measures following changes in recent practice guidelines, and will continue to evolve in the future.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas
EPOSTER ONLY: COVERAGE OF CLOSTRIDIOIDES DIFFICILE ANTIBIOTICS IN MEDICARE: 2015 TO 2023 (Hall A, Poster Hall - Walter E. Washington Convention Center) - Mar 14, 2024 - Abstract #DDW2024DDW_6858;
However, more plans started to require prior authorizations and imposed quantity limits for fidaxomicin, and ~75% of the plans place fidaxomicin as Tier 3 or above, which imposes higher financial burden on patients. While it is encouraging to witness widespread coverage for fidaxomicin, further research is warranted to understand downstream implications on CDI treatment.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas
ANTIMICROBIAL RESISTANCE GENES AMONG FAMILIES WITH CLOSTRIDIOIDES DIFFICILE (Hall A, Poster Hall - Walter E. Washington Convention Center) - Mar 14, 2024 - Abstract #DDW2024DDW_1316;
Fourteen of the 27 (51.9%) family groups had no resistance genes identified in either the infant or the parents. Among the 13 remaining families only family group 9 had a 100% correlation between the resistance genes identified in the parents and the infant.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas, Zinplava (bezlotoxumab) / Merck (MSD)
Review, Journal: The management of Clostridioides difficile infection: from empirism to evidence. (Pubmed Central) - Feb 12, 2024
There is growing literature on fecal microbiota transplantation (FMT) and the 2021 guidelines describe its role in severe complicated refractory CDI cases and for which surgical management is not feasible. Moreover, there are new data on the secondary prophylaxis with VAN in refractory CDI in patients with risk factors who receive broad spectrum antibiotics.
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas
Journal: Host-defense piscidin peptides as antibiotic adjuvants against Clostridioides difficile. (Pubmed Central) - Jan 26, 2024
The variations in effects obtained with the different forms of the peptides reveal that while all piscidins generally sensitize C. difficile to antibiotics, co-treatments can be optimized in accordance with the underlying mechanism of action of the peptides and antibiotics. Overall, this study highlights the potential of antimicrobial peptides as antibiotic adjuvants to increase the lethality of currently approved antibiotic dosages, reducing the risk of incomplete treatments and ensuing drug resistance.
- |||||||||| Journal: European Practice for CDI Treatment. (Pubmed Central) - Jan 8, 2024
The findings of this study suggest that the use of fidaxomicin for treatment of CDI reduces poor outcomes in patients who are immunocompromised. Approval pre-prescription was required before vancomycin (n
- |||||||||| Dificid (fidaxomicin) / Merck (MSD), Astellas, Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
Journal: Ribotypes and antimicrobial susceptibility profiles of clinical Clostridioides difficile isolates: A multicenter, laboratory-based surveillance in Taiwan, 2019-2021. (Pubmed Central) - Dec 23, 2023
A limitation of this study may that more studies are needed to compare fidaxomicin with other antibiotics. Vancomycin, fidaxomicin, and metronidazole remain in
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