c-diff
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New Treatment for Clostridium Difficile Infection
Fidaxomicin is a new antibiotic that is soon to be released by the FDA for Clostridium Difficile Infections in adults. This new drug is a macrocyclic RNA polymerase inhibitor. It has narrow spectrum of activity, almost C-Diff specific. Since monitoring the 1990’s of C-Diff has reached an all time high. Research shows that it has a higher clinical cure rate than it current treatment, oral vancomycin and metronidazole. Research also shows that there are fewer patient relapse following initial treatment.
Current Treatment: Limit use of antibiotics. If antibiotics are needed for prolonged durations probiotics are recommended. Avoid the use of antiperistalsis agent that may precipitate toxic mega colon. For mild to moderate cases of C- Diff metronidazole 500mg orally three times per day for 10-14 days. Vancomycin 125mg orally four times a day for 10-14 days is drug of choice for severe cases. If there is an ileus vancomycin can be administered rectally. IV metronidazole may be administered for complicated cases. IV vancomycin is not used for C-Diff because it does not reach the colon for absorption. Therefore patients may be on two forms of vancomycin for two different infections.
Dosage and Administration: Study Phase III trial administered 200mg of fidaxomicin oral dose every 12 hours for 10 days. This is most likely the recommended dose.
Clinical Efficacy: With the above dosing researchers are getting clinical cure rates of 88.2% over vancomycin of 85.8% and recurrence rates of 15.4% over vancomycin of 25.3%. Fidaxomicin has faster resolution of C-Diff symptoms of 60 hours due to the high fecal concentrations, nearly 100%.
Safety and Tolerability: No major adverse reactions and no recognized drug interactions.
This drug is not on the market as of yet. The FDA is trying to push fidaxomicin through the last stages of trials because of its statistics and promise for C-Diff infection. Fidaxomicin is expected to released by June/July.
Brief Update: A Call to Action
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I know it’s been a long time since I posted anything here. Life intervened.
Since it’s Nov 1st and the start of NaNoWriMo, I know I’ll be formulating a writing ritual. I might as well add the blog as another of my writing outlets. I tend to thrive on peer pressure, so if you’d like to add me as a writing buddy, my username is “igeekrn”. I promise to follow you back and support you on your project…quest….thing. I have a rough plot and some character sketches but haven’t started the novel itself. Once I get a bit more clear on the project, I’ll post some updates and maybe a snippet or two of the more coherent parts.
