Clinical Efficacy of Fidaxomicin and Oral Metronidazole for Treating Clostridioides difficile Infection and the Associated Recurrence Rate: A Retrospective Cohort Study

被引:3
作者
Mori, Nobuaki [1 ,2 ]
Hirai, Jun [1 ,2 ]
Ohashi, Wataru [3 ]
Asai, Nobuhiro [1 ,2 ]
Shibata, Yuichi [2 ]
Mikamo, Hiroshige [1 ,2 ]
机构
[1] Aichi Med Univ, Dept Clin Infect Dis, 1-1 Yazakokarimata, Nagakute, Aichi 4801195, Japan
[2] Aichi Med Univ, Dept Infect Prevent & Control, 1-1 Yazakokarimata, Nagakute, Aichi 4801195, Japan
[3] Aichi Med Univ, Clin Res Ctr, Div Biostat, 1-1 Yazakokarimata, Nagakute, Aichi 4801195, Japan
来源
ANTIBIOTICS-BASEL | 2023年 / 12卷 / 08期
关键词
Clostridioides difficile infection; efficacy; fidaxomicin; oral metronidazole; treatment failure; MANAGEMENT; GUIDELINES; RESISTANCE; VANCOMYCIN; SOCIETY;
D O I
10.3390/antibiotics12081323
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Clostridioides difficile infection (CDI) has significant implications for healthcare economics. Although clinical trials have compared fidaxomicin (FDX) and vancomycin, comparisons of FDX and oral metronidazole (MNZ) are limited. Therefore, we compared the therapeutic effects of FDX and oral MNZ. Patients diagnosed with CDI between January 2015 and March 2023 were enrolled. Those treated with oral MNZ or FDX were selected and retrospectively analyzed. The primary outcome was the global cure rate. Secondary outcomes included factors contributing to the CDI global cure rate; the rate of medication change owing to initial treatment failure; and incidence rates of clinical cure, recurrence, and all-cause mortality within 30 days. Of the 264 enrolled patients, 75 and 30 received initial oral MNZ and FDX treatments, respectively. The corresponding CDI global cure rates were 53.3% and 70% (p = 0.12). In multivariate analysis, FDX was not associated with the global cure rate. In the MNZ group, 18.7% of the patients had to change medications owing to initial treatment failure. The FDX group had a higher clinical cure rate and lower recurrence rate than the MNZ group, although not significant. However, caution is necessary owing to necessary treatment changes due to MNZ failure.
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页数:9
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