Universität zu Köln

Cornely, Oliver A., Vehreschild, Maria J. G. T., Adomakoh, Nicholas, Georgopali, Areti, Karas, Andreas, Kazeem, Gbenga and Guery, Benoit (2019). Extended-pulsed fidaxomicin versus vancomycin for Clostridium difficile infection: EXTEND study subgroup analyses. Eur. J. Clin. Microbiol. Infect. Dis., 38 (6). S. 1187 - 1195. NEW YORK: SPRINGER. ISSN 1435-4373

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Abstract

Poor outcomes following Clostridium difficile infection (CDI) have been associated with advanced age, presence of cancer and C. difficile PCR-ribotype 027. The impact of baseline risk factors on clinical outcomes was evaluated using data from the EXTEND study, in which rate of sustained clinical cure (SCC) in the overall population was significantly higher with an extended-pulsed fidaxomicin (EPFX) regimen than with vancomycin. Patients aged 60years received EPFX (fidaxomicin 200mg twice daily, days 1-5; once daily on alternate days, days 7-25) or vancomycin (125mg four times daily, days 1-10). We analysed outcomes by advanced age, cancer diagnosis, CDI severity, prior CDI occurrence and infection with PCR-ribotype 027. The primary endpoint was SCC 30days after end of treatment (EOT; clinical response at test-of-cure with no subsequent recurrence). SCC rates 30days after EOT did not differ significantly between EPFX (124/177, 70.1%) and vancomycin (106/179, 59.2%) regardless of age, cancer diagnosis, CDI severity and prior CDI. In patients with PCR-ribotype 027, SCC rate 30days after EOT was significantly higher with EPFX (20/25, 80%) than with vancomycin (9/22, 40.9%) (treatment difference, 39.1%; 95% CI, 13.2-64.9; P=0.006). Subgroup analyses from the EXTEND study suggest that EPFX is efficacious as a potential treatment for CDI regardless of age, cancer diagnosis, infection with PCR-ribotype 027, CDI severity or prior CDI. ClinicalTrials.gov identifier: NCT02254967.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Cornely, Oliver A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, Maria J. G. T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Adomakoh, Nicholas UNSPECIFIED UNSPECIFIED UNSPECIFIED Georgopali, Areti UNSPECIFIED UNSPECIFIED UNSPECIFIED Karas, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Kazeem, Gbenga UNSPECIFIED UNSPECIFIED UNSPECIFIED Guery, Benoit UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-147073
DOI:	10.1007/s10096-019-03525-y
Journal or Publication Title:	Eur. J. Clin. Microbiol. Infect. Dis.
Volume:	38
Number:	6
Page Range:	S. 1187 - 1195
Date:	2019
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1435-4373
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HOSPITALIZED-PATIENTS; RECURRENCE RATES; OUTCOMES; CANCER; MULTICENTER; DIARRHEA Multiple languages Infectious Diseases; Microbiology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14707