Date of Paper/Work

5-2012

Type of Paper/Work

Scholarly project

Degree Name

Master of Arts in Nursing

Department

Nursing

Advisor(s)

Vicki Ericson

Abstract

Clostridium difficile has been historically viewed as a hospital acquired infection. However, the emergence of community acquired infection in low risk populations, the identification of new risk factors, detection of a hypervirulent strain of C. difficile, and increasing mortality have changed the epidemiology if this infection. Current standards of treatment have come into question due to increasing recurrence rates and treatment failures, possible resistance of Metronidazole, and concerns surrounding Vancomycin resistant enterococci (VRE). Fidaxomicin, a narrow-spectrum macrolide, is the first drug approved by the FDA in 20 years for the treatment of C. difficile infection. It has shown good in vitro and in vivo activity, has similar clinical cure rates, lower recurrence rates, and higher global cure rates compared to Vancomycin in non-hypervirulent strains and similar efficacy in all outcomes in the hypervirulent strain. Overall, Fidaxomicin appears to be a reasonable second line treatment option for recurrent C. difficile infection in patients who have failed to respond to treatment under the current guidelines.

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