Fidaxomicin (Dificid) & C Difficile

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 Fidaxomicin 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 Fidaxomicin 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?

Fidaxomicin 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

Recent Fidaxomicin News

14 thoughts on “Fidaxomicin (Dificid) & C Difficile

  1. Roselle tazza

    Thank you soo much for your knowledge! I was a pediatric nurse but I am lacking when dealing with these super bugs!

    Reply
  2. Infection Watch

    Fidax is very expensive and they will always want to hold on to it to help prevent resistance through over prescription. It’s up to you re stool culture but I would be guided by symptoms rather than concern to eradicate

    Please note that I am a medical journalist widely read in this subject but not an MD or infection specialist

    Reply
  3. roselle

    Thank you! We asked for the other drug and were told no, as this is the protocol to start with. Both my sister and niece have had CDiff. My niece did well with just Flagyll, but my sister only had success with Fidaxomicin! Should I get a repeat culture for the stool after she is finished with the antibiotics? I was told unless there is symptoms, they do not do a repeat stool culture??

    Reply
  4. roselle

    My mom is 85 yrs old and got CDIFF from taking Cezfzil for a UTI. Her doctor put her on Vancomycin and Flagyl at the same time. How long does it take before a formed stool can be had. And does this mean if there is no diarrhea, there is no bacteria??? How do u know the medication is working??

    Reply
    1. Infection Watch

      The combination your mom has been given is fairly efficient at halting c diff and will probably work within 7-10 days. Many of us have c diff lingering in our systems and it may not be eradicated but return to lurking without infection.

      Fidaxomicin is much more efficient at eliminating it.

      Dave Roberts
      cdifficile.org

      Reply

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