Many factors influence patients’ risk of Clostridium difficile-associated diarrhea (CDAD) and its recurrence

Contracting CDAD

Many factors influence patients’ risk of Clostridium difficile-associated diarrhea (CDAD)

Disruption of normal gut flora1

  • Antibiotic exposure within 3 months
  • Medications affecting intestinal tract
  • Chemotherapy
  • GI procedures

Increased exposure1

  • Admission to hospital or long-term care
  • Poor hand hygiene
  • Infected hospital roommate
  • Prior CDAD episode

MOST CASES ARE ASSOCIATED WITH PREVIOUS ANTIBIOTIC USE
FOR ANOTHER INFECTION, WHICH DISRUPTS THE NORMAL
GUT FLORA, ALLOWING C. DIFFICILE TO PROLIFERATE1

Identifying Patients at Risk

Many patients are at risk for Clostridium difficile-associated diarrhea (CDAD) and its recurrence2,3

AGED 65 YEARS OR OLDER. FEMALE GENDER. MULTIPLE COMORBIDITIES. INMUNOCOMPROMISED.

 

20%-30%

DESPITE HIGH RATES OF SUCCESS IN
TREATMENT OF THE INITIAL INFECTION,
CDAD GOES ON TO RECUR IN
APPROXIMATELY 20% to 30% OF PATIENTS4,5
 

  • Patients who experience CDAD recurrence typically do so within 1 to 3 weeks after completion of therapy for the initial infection6-8
Diagnosing CDAD

Diagnosing Clostridium difficile-associated diarrhea (CDAD)

  • A Clostridium difficile infection (CDI) case is defined as the presence of symptoms, usually diarrhea (3 or more unformed stools in ≤24 hours) and either3:
    • A positive stool test for toxigenic C. difficile or related toxins

    • Evidence of pseudomembranous colitis (colonoscopy or histopathology)

  • The disease can vary from asymptomatic to mild symptoms to fatal colitis9

  • Cell toxicity assays are the current “gold standard” for detection of C. difficile toxins, and toxin immunoassays are widely used. Other diagnostic laboratory tests include glutamate dehydrogenase immunoassays, cell cultures, and polymerase chain reaction for toxin genes3
    • Testing should be performed only on diarrheal (unformed) stools except in rare instances3
    • Asymptomatic patients should not be tested even for test of cure3

 

Important Safety Information

  • DIFICID is contraindicated in patients with hypersensitivity to fidaxomicin
  • DIFICID should not be used for systemic infections
  • Acute hypersensitivity reactions (angioedema, dyspnea, pruritus, and rash) have been reported. In the event of a severe reaction, discontinue DIFICID.
  • Only use DIFICID for infection proven or strongly suspected to be caused by C. difficile.
    Prescribing DIFICID in the absence of a proven or strongly suspected C. difficile infection is unlikely to provide benefit to the patient and increases the risk of the development of drug- resistant bacteria.
  • The most common adverse reactions reported in clinical trials are nausea (11%), vomiting (7%), abdominal pain (6%), gastrointestinal hemorrhage (4%), anemia (2%), and neutropenia (2%)

 

Indications and Usage

  • DIFICID is a macrolide antibacterial drug indicated in adults ≥18 years of age for treatment of Clostridium difficile-associated diarrhea
  • To reduce the development of drug-resistant bacteria and maintain the effectiveness of DIFICID and other antibacterial drugs, DIFICID should be used only to treat infections that are proven or strongly suspected to be caused by Clostridium difficile

 

Please click here for full prescribing information for DIFICID.