Fidaxomicin and vancomycin provide similar initial cure in C difficile, death rate


Clostridioides difficile (it’s hard) anti-infective therapies, fidaxomicin and vancomycin differ significantly in patient outcomes for initial cure or mortality, according to the results of a new systematic review of the literature and a meta-analysis.

In new data presented at the 2021 annual meeting of Making A Difference in Infectious Disease (MAD-ID), a team of Rhode Island-based investigators reported similarities in clinical outcomes between the 2 agents in patients treated in 3 different randomized controlled trials.

That said, the report – presented by J. Xin Liao, PharmD, of Providence Veterans Affairs Medical Center – showed differences in it’s hard recurrence among fidaxomicin and vancomycin. The result may indicate a more viable first-line treatment strategy to reduce the recurrence of infection, a major burden in those affected. VS difficult patients.

Current national guidelines recommend fidaxomicin or vancomycin as both primary therapy VS difficult infection, wrote Liao and colleagues. The team sought to interpret the possibilities of one agent’s preference over another, in order to optimize treatment strategies.

Researchers conducted a systematic literature review of relevant clinical trial databases up to February 2021 for randomized, controlled studies comparing guideline recommended regimens of vancomycin and fidaxomicin for treatment. it’s hard in adult patients.

They looked for the main endpoints of initial healing 2 days after treatment, as well as recurrence of infection and mortality 1 month after treatment. Their meta-analysis of eligible trials was conducted via random-effects modeling.

The team’s final assessment included 3 randomized controlled trials comprising a total of 1359 patients; 668 were treated with fidaxomicin and 691 with vancomycin. The mean age of the patients during the study was 64.4 years. More than a third (38.9%) of patients were classified it’s hard infection.

Initial cure was prevalent in 87.2% of patients treated with fidaxomicin compared with 86.5% of patients treated with vancomycin. Mortality at 1 month occurred in 5.8% and 5.9% of treated patients, respectively.

Investigators observed a decrease of about 42% it’s hard probability of recurrence in patients treated with fidaxomicin (RR, 0.58; 95% CI, 0.45 – 0.75; P <.0004 compared to vancomycin.>

Liao and his colleagues indeed concluded that first-line therapies did not differ significantly in terms of initial cure or short-term mortality for it’s hard treatment of infections.

“However, fidaxomicin was associated with a lower risk of CDI recurrence compared to vancomycin one month after treatment,” they wrote. “These results indicate that fidaxomicin may be preferred as a first-line treatment over vancomycin to minimize recurrence of CDI.”


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