The efficacy of fidaxomicin in the treatment of Clostridium difficile infection in a real-world clinical setting: a Spanish multi-centre retrospective cohort
Por:
Feher, C, Munez Rubio, E, Merino Amador, P, Delgado-Iribarren Garcia-Campero, A, Salavert, M, Merino E, Maseda Garrido, E, Diaz-Brito, V, Alvarez, M and Mensa, J
Publicada:
1 feb 2017
Resumen:
The objective of this study was to evaluate the efficacy and safety of
fidaxomicin in the real-life clinical setting. This was a retrospective
cohort of patients with Clostridium difficile infection (CDI) treated
with fidaxomicin in 20 Spanish hospitals between July 2013 and July
2014. Clinical cure, 30-day recurrence, 30-day mortality, sustained
cure, and factors associated with the failure to achieve sustained cure
were analyzed. Of the 72 patients in the cohort 41 (56.9 %) had a fatal
underlying disease. There were 44 (61.1 %) recurrent episodes and 26
cases (36.1 %) with a history of multiple recurrences. Most episodes
were severe (26, 36 %) or severe-complicated (14, 19.4 %). Clinical cure
rate was 90.3 %, recurrence rate was 16.7 % and three patients (4.2 %)
died during the follow-up period. Sustained cure was achieved in 52
cases (72.2 %). Adverse events were reported in five cases (6.9 %).
Factors associated with the lack of sustained cure were cardiovascular
comorbidity (OR 11.4; 95 %CI 1.9-67.8), acute kidney failure (OR 7.4; 95
%CI 1.3-43.1), concomitant systemic antibiotic treatment (OR 6.2; 95 %CI
1.1-36.8), and C-reactive protein value at diagnosis (OR 1.2 for each 1
mg/dl increase; 95 %CI 1.03-1.3). Fidaxomicin is an effective and well
tolerable treatment for severe CDI and for cases with elevated
recurrence risk.
Filiaciones:
Feher, C:
Hosp Clin Barcelona, Dept Infect Dis, C Villarroel 170, Barcelona 08036, Spain
Munez Rubio, E:
Hosp Univ Puerta de Hierro, Dept Internal Med, Infect Dis Unit, Madrid, Spain
Merino Amador, P:
Hosp Clin San Carlos, Dept Microbiol, Madrid, Spain
Delgado-Iribarren Garcia-Campero, A:
Fdn Hosp Alcorcon, Dept Microbiol, Madrid, Spain
Salavert, M:
Hosp Univ La Fe, Infect Dis Unit, Valencia, Spain
Politecn La Fe, Infect Dis Unit, Valencia, Spain
Merino E:
Hosp Gen Univ Alicante, Infect Dis Unit, Alicante, Spain
Maseda Garrido, E:
Hosp Univ La Paz, Dept Anesthesiol & Crit Surg Care, Madrid, Spain
Diaz-Brito, V:
Parc Sanitari St Joan de Deu, Infect Dis Unit, Barcelona, Spain
Alvarez, M:
Hosp Clin Barcelona, Dept Microbiol, Barcelona, Spain
Mensa, J:
Hosp Clin Barcelona, Dept Infect Dis, C Villarroel 170, Barcelona 08036, Spain
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