Fidaxomicin (trade name Dificid) is a new type of antibiotic. It is taken orally and has a low impact on the bloodstream. It kills the target bacteria and has been shown to kill Clostridium difficile without attacking the many healthy bacteria found in the normal, healthy intestine. This in turn lessens the chance of further C Diff attacks.
Dificid and Dificlr
These are 2 of the trade names under which it is marketed around the world. Studies looking at the effectiveness of the drug are common and links to these can be found below.
When is Fidaxomicin prescribed?
Because it is a recently developed drug it is expensive. It is therefore likely to be prescribed when other C.difficile drugs have failed. Given the expense of treating C. difficile some make a case for prescribing it for moderate cases as the cost of prolonged treatment may be more than the short term cost of Fidaxomicin.
This is reinforced by a study that suggests that patients treated with Dificid shed less c difficile in their surroundings. This has a significant impact on transmission in the hospital context. This is clearly a positive for other patients but reductions in C Diff rates mean less likelihood of financial penalties from government bodies and will be a goal that insurers will want to encourage as it lowers their cost.
How does Fidaxomicin work?
It has been developed by Optimer Pharmaceuticals. It works by inhibiting the bacterial enzyme RNA polymerase. This results in the death of the Clostridium difficile bacteria. This in turn means that further attacks are less common when treated with this drug.
Studies into length of treatment suggest that 5 days is barely enough. 20 days is too much with respect to a small number of other gut bacteria impacted by Dificid that need time to recover. Tapered dosing patterns both inhibit the infection and give the stomach flora some time to recover.
Are there known side effects?
Studies so far show these to be mild. They include ‘feeling hot’ and a daytime sleepiness condition called hypersomnia.
In depth medical background
For more technical information and the background to Fidaxomicin (Dificid) check Wikipedia
Other C Difficile Drugs & Treatment
- Fidaxomicin (Dificid) & C Difficile – 6 key facts you should know
- Flagyl (Metronidazole) & C Difficile Treatment
- Vancocin & C Difficile – 4 Key Facts For You
- C Diff Fecal Transplant Therapy – 7 Key Facts
- Why do some people have recurrent C Diff infections?
Recent Fidaxomicin News
- PLOS ONE: Association of Fidaxomicin with C. difficile Spores: Effects of Persistence on Subsequent Spore Recovery, Outgrowth and Toxin Production
- How Often is Fidaxomicin Used for C. difficile Infection?
- New antibiotics in clinical trials for Clostridium difficile. - PubMed - NCBI
- Effect of fidaxomicin versus vancomycin on susceptibility to intestinal colonization with vancomycin-resistant enterococci and Klebsiella pneumoniae in mice
- A pilot study to assess bacterial and toxin reduction in patients with Clostridium difficile infection given fidaxomicin or vancomycin. - PubMed - NCBI
- Antibacterials Developed to Target a Single Organism: Mechanisms and Frequencies of Reduced Susceptibility to the Novel Anti-Clostridium difficile ... - PubMed - NCBI