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https://www.readbyqxmd.com/read/27917075/management-of-clostridium-difficile-infection
#1
Layth S Al-Jashaami, Herbert L DuPont
Since the discovery of Clostridium difficile infection (CDI) in the 1970s, there has been an increase in the incidence, severity, and recurrence rate of the disease. We reviewed the recent CDI literature in PubMed published before February 28, 2016 that focused on advances in therapy. Despite a large number of studies describing methods for diagnosing the disease, there is currently no definitive test that identifies this infection with certainty, which complicates therapy. Recommended therapy for CDI includes oral metronidazole for mild cases and oral vancomycin or fidaxomicin for moderate to severe cases, each given for 10 to 14 days...
October 2016: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27896376/reducing-the-bottleneck-in-discovery-of-novel-antibiotics
#2
Marcus B Jones, William C Nierman, Yue Shan, Bryan C Frank, Amy Spoering, Losee Ling, Aaron Peoples, Ashley Zullo, Kim Lewis, Karen E Nelson
Most antibiotics were discovered by screening soil actinomycetes, but the efficiency of the discovery platform collapsed in the 1960s. By now, more than 3000 antibiotics have been described and most of the current discovery effort is focused on the rediscovery of known compounds, making the approach impractical. The last marketed broad-spectrum antibiotics discovered were daptomycin, linezolid, and fidaxomicin. The current state of the art in the development of new anti-infectives is a non-existent pipeline in the absence of a discovery platform...
November 28, 2016: Microbial Ecology
https://www.readbyqxmd.com/read/27876339/diagnosis-and-treatment-of-clostridium-difficile-c-diff-colitis-review-of-the-literature-and-a-perspective-in-gynecologic-oncology
#3
REVIEW
Kristin N Taylor, Michael T McHale, Cheryl C Saenz, Steven C Plaxe
Clostridium difficile infection (CDI) is a major cause of nosocomial diarrhea with the potential for significant morbidity and mortality. Colonization in a susceptible individual, with risk factors such as prior antibiotic use, advanced age, or medical comorbidities, may result in symptomatic infection. Although patients with a gynecologic malignancy may be at a higher risk of developing CDI due to an increased likelihood of having one or more risk factors, data do not consistently support the idea that chemotherapy or cancer itself are independently associated with CDI...
November 19, 2016: Gynecologic Oncology
https://www.readbyqxmd.com/read/27862113/rethinking-strategies-to-select-antibiotic-therapy-in-cdi
#4
Teena Chopra, Ellie J C Goldstein, Sherwood L Gorbach
In recent years, Clostridium difficile infection (CDI) has become a global public health threat associated with increased morbidity, mortality, and economic burden, all of which are exacerbated with disease recurrence. Current guidelines informing treatment decisions are largely based on definitions of disease severity at diagnosis, with subjective components not well delineated across treatment algorithms and clinical trials. Furthermore, there is little evidence linking severity at onset to outcome. However, reducing the risk of recurrence may offer both a better outcome for the individual and decreased downstream economic impact...
November 9, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27796474/-clostridium-difficile-infection-what-is-currently-available-for-treatment
#5
A Stallmach
Clostridium difficile (C. difficile) is an anaerobic, Gram-positive, spore-forming, toxin-secreting bacillus. It is transmitted via a fecal-oral route and can be found in 1-3 % of the healthy population. Symptoms caused by C. difficile range from uncomplicated diarrhea to a toxic megacolon. The incidence, frequency of recurrence, and mortality rate of C. difficile infections (CDIs) have increased significantly over the past few decades. The most important risk factor is antibiotic treatment in elderly patients and patients with severe comorbidities...
December 2016: Der Internist
https://www.readbyqxmd.com/read/27785569/-clostridium-difficile-infections-in-geriatric-patients
#6
R Simmerlein, A Basta, M Gosch
Clostridium difficile is the main cause of nosocomial antibiotic-associated diarrhea in adults in Europe and North America. Infections with C. difficile typically occur in elderly patients with comorbidities and prior antibiotic therapy. Other risk factors are proton pump inhibitors, which are taken by many elderly patients. The main virulence factors are toxins A and B. The clinical spectrum ranges from asymptomatic colonization to severe disease with abdominal complications and sepsis. The current diagnostic gold standard is anaerobic culture but is impractical in routine use due to the long duration...
October 26, 2016: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/27770261/epidemiology-and-recurrence-rates-of-clostridium-difficile-infections-in-germany-a-secondary-data-analysis
#7
Christoph Lübbert, Lisa Zimmermann, Julia Borchert, Bernd Hörner, Reinier Mutters, Arne C Rodloff
INTRODUCTION: Clostridium difficile infection (CDI) is the most common cause of health-care-associated infectious diarrhea. Recurrence rates are as high as 20-30% after standard treatment with metronidazole or vancomycin, and appear to be reduced for patients treated with fidaxomicin. According to the literature, the risk of CDI recurrence increases after the second relapse to 30-65%. Accurate data for Germany are not yet available. METHODS: Based on the research database of arvato health analytics (Munich, Germany), a secondary data analysis for the incidence, treatment characteristics and course of CDI was performed...
October 21, 2016: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/27718071/the-efficacy-of-fidaxomicin-in-the-treatment-of-clostridium-difficile-infection-in-a-real-world-clinical-setting-a-spanish-multi-centre-retrospective-cohort
#8
C Fehér, E Múñez Rubio, P Merino Amador, A Delgado-Iribarren Garcia-Campero, M Salavert, E Merino, E Maseda Garrido, V Díaz-Brito, M J Álvarez, J Mensa
The objective of this study was to evaluate the efficacy and safety of fidaxomicin in the real-life clinical setting. This was a retrospective cohort of patients with Clostridium difficile infection (CDI) treated with fidaxomicin in 20 Spanish hospitals between July 2013 and July 2014. Clinical cure, 30-day recurrence, 30-day mortality, sustained cure, and factors associated with the failure to achieve sustained cure were analyzed. Of the 72 patients in the cohort 41 (56.9 %) had a fatal underlying disease...
October 8, 2016: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/27664230/faecal-microbiota-transplantation-for-recurring-clostridium-difficile-infection-in-a-patient-with-crohn-s-disease-and-ileorectal-anastomosis
#9
Asser Mathiassen Oppfeldt, Jens F Dahlerup, Lisbet A Christensen, Christian L Hvas
Faecal microbiota transplantation (FMT) is increasingly being used to treat refractory and recurring Clostridium difficile infection (CDI). Although FMT appears to be safe and highly effective in patients with a preserved colon and immunocompetence, its use in patients with inflammatory bowel disease (IBD) who are on immunomodulating therapies is controversial. In particular, patients who have undergone colectomy may have different treatment responses to FMT. In this case report, we describe the successful use of FMT in a female patient aged 19 years with Crohn's disease who underwent ileorectal anastomosis following colectomy...
2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27606976/the-epidemiology-of-clostridium-difficile-infection-in-patients-with-cancer
#10
Andrew I T Hebbard, Monica A Slavin, Caroline Reed, Benjamin W Teh, Karin A Thursky, Jason A Trubiano, Leon J Worth
Clostridium difficile infection (CDI) is a significant cause of healthcare-associated diarrhoea, and the emergence of endemic strains resulting in poorer outcomes is recognised worldwide. Patients with cancer are a specific high-risk group for development of infection. Areas covered: In this review, modifiable and non-modifiable risk factors for CDI in adult patients with haematological malignancy or solid tumours are evaluated. In particular, the contribution of antimicrobial exposure, hospitalisation and gastric acid suppression to risk of CDI are discussed...
November 2016: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/27601193/-a-scoring-system-for-prescribing-fidaxomicin-in-clostridium-diff%C3%A3-cile-infection
#11
María Jesús Vivancos-Gallego, M Ángeles Jiménez-López, Francesca Gioia, Dione Ibañez-Segura, José Romero-Vivas, Javier Cobo
Recurrences of Clostridium difficile infections lead to hospital readmissions and high costs, in addition to the suffering and frustration for the patients. Fidaxomicin has recently been introduced as a new antibiotic that has been shown to significantly reduce the recurrence of this infection. Despite this superiority, its high cost has led to very restrictive policies in its use, as such that many institutions only use it in patients with multiple recurrences. While waiting for new predictive clinical tools, we propose the development of scoring systems that allow the more high-risk patients to be treated earlier...
September 3, 2016: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/27556739/association-of-fidaxomicin-with-c-difficile-spores-effects-of-persistence-on-subsequent-spore-recovery-outgrowth-and-toxin-production
#12
Caroline H Chilton, Grace S Crowther, Helen Ashwin, Chris M Longshaw, Mark H Wilcox
BACKGROUND: We have previously shown that fidaxomicin instillation prevents spore recovery in an in-vitro gut model, whereas vancomycin does not. The reasons for this are unclear. Here, we have investigated persistence of fidaxomicin and vancomycin on C. difficile spores, and examined post-antibiotic exposure spore recovery, outgrowth and toxin production. METHODS: Prevalent UK C. difficile ribotypes (n = 10) were incubated with 200mg/L fidaxomicin, vancomycin or a non-antimicrobial containing control for 1 h in faecal filtrate or Phosphate Buffered Saline...
2016: PloS One
https://www.readbyqxmd.com/read/27536508/a-multi-center-study-of-fidaxomicin-use-for-clostridium-difficile-infection
#13
Dhara N Shah, Fay S Chan, Nandita Kachru, Krutina P Garcia, Holly E Balcer, April P Dyer, John E Emanuel, Michelle D Jordan, Katherine T Lusardi, Geri Naymick, Radhika S Polisetty, Lanny Sieman, Ashley M Tyler, Michael L Johnson, Kevin W Garey
PURPOSE: Fidaxomicin use in real-world clinical practice, especially for severe Clostridium difficile infection (CDI), is mainly based on single-center observational studies. The purpose of this pharmacoepidemiology study was to assess outcomes of patients given fidaxomicin based on episode number and use of concomitant antibiotics. METHODS: Fidaxomicin use over time across included hospitals in the United States was assessed using a large inpatient drug utilization database...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27536153/an-update-on-antibody-based-immunotherapies-for-clostridium-difficile-infection
#14
REVIEW
Greg Hussack, Jamshid Tanha
Clostridium difficile continues to be one of the most prevalent hospital-acquired bacterial infections in the developed world, despite the recent introduction of a novel and effective antibiotic agent (fidaxomicin). Alternative approaches under investigation to combat the anaerobic Gram-positive bacteria include fecal transplantation therapy, vaccines, and antibody-based immunotherapies. In this review, we catalog the recent advances in antibody-based approaches under development and in the clinic for the treatment of C...
2016: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/27429316/review-naats-diagnose-c-difficile-vancomycin-improves-cure-and-fidaxomicin-reduces-recurrence
#15
Fred Arthur Zar
No abstract text is available yet for this article.
July 19, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27410763/new-antibiotics-in-clinical-trials-for-clostridium-difficile
#16
Eric T Slayton, Abigail S Hay, Charles K Babcock, Timothy E Long
INTRODUCTION: There are limited number of approved therapies for C. difficile infections (CDIs) and new treatments are needed to decrease recurrence rates. Over the past 5 years, four novel antibiotics have been evaluated in clinical trials that offer distinct advantages over existing therapies for the treatment of CDI. AREAS COVERED: This article reviews the preclinical and clinical studies of cadazolid, LFF571, ridinilazole, and surotomycin. The advantages that these antibiotics may have in the treatment of CDI is compared with current therapies metronidazole, vancomycin, and fidaxomicin...
July 25, 2016: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/27366179/fidaxomicin-versus-vancomycin-in-the-treatment-of-clostridium-difficile-infection-canadian-outcomes
#17
Christine Lee, Thomas J Louie, Karl Weiss, Louis Valiquette, Marvin Gerson, Wendy Arnott, Sherwood L Gorbach
Background. This analysis examined the efficacy of fidaxomicin versus vancomycin in 406 Canadian patients with Clostridium difficile infection (CDI), based on data from 2 randomized, clinical trials. Methods. Patients received fidaxomicin or vancomycin 1. Patients were assessed for clinical response recurrence of infection and sustained clinical response for 28 days after treatment completion. Patients at increased risk of recurrence were subjected to subgroup analyses. Results. Clinical response rates for fidaxomicin (90...
2016: Canadian Journal of Infectious Diseases & Medical Microbiology
https://www.readbyqxmd.com/read/27246640/-antibiotic-treatment-of-clostridial-colitis
#18
J Beneš, S Polívková
The advantages and disadvantages of various antibiotics used in the treatment of Clostridium difficile infection (CDI) are compared with respect to their pharmacokinetic and pharmacodynamic properties. Recommendations are made for their optimal use in clinical practice. Metronidazole is suitable for the treatment of mild forms of CDI which are essentially self-limiting. Vancomycin kills clostridia reliably but the treatment is encumbered with considerable risk of recurrence. This can be decreased by shortening the treatment to seven days and then switching to a (pulse, taper, chaser) regimen to prevent recurrence or by active restoration of the intestinal ecosystem (fecal transplant)...
2016: Epidemiologie, Mikrobiologie, Imunologie
https://www.readbyqxmd.com/read/27239977/progress-in-the-fight-against-multidrug-resistant-bacteria-a-review-of-u-s-food-and-drug-administration-approved-antibiotics-2010-2015
#19
Dalia Deak, Kevin Outterson, John H Powers, Aaron S Kesselheim
A weak antibiotic pipeline and the increase in drug-resistant pathogens have led to calls for more new antibiotics. Eight new antibiotics were approved by the U.S. Food and Drug Administration (FDA) between January 2010 and December 2015: ceftaroline, fidaxomicin, bedaquiline, dalbavancin, tedizolid, oritavancin, ceftolozane-tazobactam, and ceftazidime-avibactam. This study evaluates the development course and pivotal trials of these antibiotics for their innovativeness, development process, documented patient outcomes, and cost...
September 6, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27130808/clostridium-difficile-clade-5-in-australia-antimicrobial-susceptibility-profiling-of-pcr-ribotypes-of-human-and-animal-origin
#20
Daniel R Knight, Thomas V Riley
OBJECTIVES: Increasing reports of genetic overlap between animal and human sources of Clostridium difficile necessitate an understanding of antimicrobial susceptibility and resistance in these populations. In this study, we sought to investigate the in vitro activities of 13 antimicrobials against a unique collection of clade 5 C. difficile isolates of Australian animal and human origin. METHODS: The collection comprised 171 C. difficile strains of human (n = 91) and animal (n = 80) origin in Australia in the last decade...
August 2016: Journal of Antimicrobial Chemotherapy
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