Cent Eur J Public Health 2018, 26(Supplement):S76-S80 | DOI: 10.21101/cejph.a5476

Single centre clinical experience with fidaxomicin in the treatment of Clostridium difficile infection in Slovakia

Martin Novotný1, Pavol Jarčuška1, Laura Gombošová3, Ján Hockicko1, Ivana Hockicková1, Alena Rovňáková1, Ondrej Zahornacký1, Ivan Schréter1, Erik Dorko2, Kvetoslava Rimárová2
1 Department of Infectology and Travel Medicine, Faculty of Medicine, Pavol Jozef Šafárik University in Košice and Louis Pasteur University Hospital, Košice, Slovak Republic
2 Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Košice, Slovak Republic
3 1st Department of Internal Medicine, Faculty of Medicine, Pavol Jozef Šafárik University in Košice and Louis Pasteur University Hospital, Košice, Slovak Republic

Objective: Clostridium difficile infection (CDI) has become one of the most common causes of hospital-acquired infections. Fidaxomicin is one of the latest antibiotics used in the treatment of CDI, however, treatment cost affects recommendations for its use in several countries. We have analysed the treatment of our patients with CDI, treated by fidaxomicin since it was introduced to the market in 2018 and became available in the second biggest Slovak hospital, University Hospital of L. Pasteur. Our aim was to determine efficacy and safety of fidaxomicin in the treatment of CDI in Slovak patients.

Methods: We reviewed all courses of fidaxomicin use in our hospital (n = 60). Fidaxomicin was used for first recurrence (12 times), second recurrence (4 times), third recurrence (2 times), and fifth recurrence (1 patient). 41 patients received fidaxomicin first-line.

Results: Success of fidaxomicin treatment was recorded at 86.7% within the whole cohort. In the recurrent Clostridium difficile infection (rCDI) subgroup, fidaxomicin was 63% effective with three patients dying (15.7%) and two patients developing subsequent rCDI. During the duration of the study, 6 patients in total died. Only one of three patients, with three or more recurrences of CDI, had no further presentations after eight weeks of completion of treatment.

Conclusions: The biggest benefit from fidaxomicin treatment was shown in a cohort of patients with primary CDI infection demonstrating a low recurrence rate and significant reduction of fidaxomicin effectiveness in preventing a recurrence when treating patients with multiple rCDI.

Keywords: Clostridium difficile infection, fidaxomicin treatment, recurrence

Received: July 4, 2018; Revised: December 28, 2018; Accepted: December 28, 2018; Published: December 31, 2018  Show citation

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Novotný M, Jarčuška P, Gombošová L, Hockicko J, Hockicková I, Rovňáková A, et al.. Single centre clinical experience with fidaxomicin in the treatment of Clostridium difficile infection in Slovakia. Cent Eur J Public Health. 2018;26(Supplement):S76-80. doi: 10.21101/cejph.a5476. PubMed PMID: 30817879.
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