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New antibiotic cuts C diff recurrence, finds UK study

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A new treatment for Clostridium difficile could significantly reduce infection recurrence, compared to current drugs, suggests a “real world” study at a London hospital.

Treatment with fidaxomicin (Dificlir) led to a reduction in recurrence for patients with C difficile versus standard of care treatment with vancomycin or metronidazole.

The study, conducted at St George’s Hospital, is the first of its kind and looked at a year’s experience using fidaxomicin as a first-line treatment for all adults confirmed to have the healthcare-associated infection.

Data from 62 patients treated with fidaxomicin during the 12 month evaluation period were compared with those from a retrospective cohort treated with vancomycin or metronidazole.

The researchers found 6% of patients treated with fidaxomicin had a recurrence of Clostridium difficile within 28 days of the end of therapy, compared with a 20% in the control group.

Importantly, there were no second recurrences reported in those treated with fidaxomicin, the study authors noted. Previous studies have shown patients who have had a recurrence have a 40% risk of a further one.

Dr Tim Planche, lead investigator and consultant microbiologist at St George’s Healthcare Trust, said the organisation had opted to use fidaxomicin over a year and a half ago for all cases of Clostridium difficile infection, after promising trial data.

St George's Hospital

Tim Planche

“Having looked at our data we are very pleased to see that we find the same effects occurring in our own ‘real world’ patients,” he said.

The findings were presented this week at the European Congress of Clinical Microbiology and Infectious Diseases in Barcelona.

Fidaxomicin is the first in a new class of macrocylic antibiotics and has been licensed by the European Medicines Agency for the treatment of Clostridium difficile infection.

The National Institute for Health and Care Excellence currently has no plans to appraise the drug.

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