Real-world effectiveness of fidaxomicin in patients at high risk of Clostridioides difficile recurrence

• DOI: 10.1017/ash.2024.381
• Publication Date: 2024-09-11T08:47:12Z
• Authors: Benjamin Colwell; Jennifer Aguilar; Frances Hughes; Pavel Goriacko; Victor Chen; Mei Chang; Rachel Bartash; Yi Guo
• Keywords: Fidaxomicin

Abstract Objective: Compare the real-world impact of fidaxomicin (FDX) and vancomycin (VAN) on Clostridioides difficile infection (CDI) recurrence in a high-risk patient population. Design: A retrospective, matched-cohort study evaluating hospitalized patients with CDI from January 1, 2016, to November 2022, within tertiary academic medical center. Patients: Adult at least 1 prior case who received either FDX or VAN for non-fulminant while admitted, had additional risk factor recurrence. Risk factors included age >70, solid organ bone marrow transplant recipients, broad-spectrum antibiotic use 30 days, receipt chemotherapy/immune-modulating agents days admission. were matched according factors. Results: total 415 admissions identified. After exclusion 92 fulminant CDI, diarrhea another cause, taper therapy, 15 unmatched patients, 308 (68 240 patients). There no significant differences 4-week (26% vs 23%; OR 1.1; P = .51), 90-day readmission (29% .65), all-cause (54% 53%; .91). was 17% decrease mortality associated (OR .3; .04). Conclusions: In population, compared oral did not result decreased 4 weeks fewer hospital readmissions 90 days. Further research is needed better assess value this