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Fidaxomicin as a Salvage Therapy for Fulminant Clostridioides difficile Infection

Caio T Heleno1, Aleksey Tagintsev1, Katharine Lasley1

  • 1Internal Medicine, MercyOne North Iowa Medical Center, Mason City, USA.

Cureus
|July 30, 2021
PubMed

Insights

Fidaxomicin shows promise in treating severe, fulminant Clostridioides difficile infection (CDI) when standard treatments fail. This case report highlights its potential as a salvage therapy for refractory cases, leading to symptom resolution.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Gastroenterology

Background:

  • Clostridioides difficile infection (CDI) guidelines recommend fidaxomicin for nonsevere and severe cases.
  • Its use in fulminant CDI is limited due to a lack of supporting randomized clinical trials.

Observation:

  • A patient with severe fulminant colitis, refractory to vancomycin and metronidazole, was treated with fidaxomicin.
  • The patient experienced significant improvement within 24 hours of initiating fidaxomicin therapy.

Findings:

  • Fidaxomicin demonstrated impressive efficacy as a salvage therapy in a case of severe fulminant CDI.
  • Complete symptom resolution was achieved without surgical intervention.

Implications:

  • This case suggests fidaxomicin may be a valuable option for refractory fulminant CDI.
  • Further clinical trials are warranted to establish its widespread use in this critical condition.
Keywords:
c. difficilefidaxomicinfulminant c. difficile infectionmetronidazoleoral vancomycin

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