Back to Course

Clostridioides difficile Infections in Adults by Sarah Kessler, PharmD, BCPS, BCGP

0% Complete
0/0 Steps

Standard Treatment

2021 First Line Therapy – Fidaxomicin

  • 2017 IDSA Guidelines
    • Oral vancomycin as 1st line therapy
  • 2021 IDSA Guidelines
    • Fidaxomicin 1st → oral vancomycin an acceptable alternative
  • Similar initial clinical response
  • Proposed Benefits of Fidaxomicin:
    • Limited documented resistance
    • Used solely for CDI
    • Ease of dosing
    • Sustained response?

Conditional Recommendation

Moderate Certainty of Evidence

Fidaxomicin in the Literature

Literature Summary

Hesitancy with Fidaxomicin?

  • Cost and Resource Allocation
    • Fidaxomicin remains rough 4x more expensive than oral vancomycin
      • Oral vancomycin remains expensive
    • Lack of insurance or lack of insurance coverage
      • Unlikely to be able to afford fidaxomicin if no insurance
      • Many insurance companies still requiring prior authorization for fidaxomicin
  • Limited number of cost-effectiveness studies – is the juice worth the squeeze?
  • IDSA guidelines place high emphasis on potential clinical benefit

Treatment Summary