
Am Fam Physician. 2022;105(6):678-679
Author disclosure: No relevant financial relationships.
Key Points for Practice
• Fidaxomicin reduces recurrence compared with vancomycin for initial and recurrent CDI.
• For patients with recurrent CDI within six months, adding bezlotoxumab to antibiotics reduces further CDI recurrence.
• Fecal microbiota transplant risks transmitting potentially fatal infections, including E. coli and SARS-CoV-2.
From the AFP Editors
Fidaxomicin Is Preferred
Although fidaxomicin (Dificid) leads to similar initial cure rates as vancomycin for CDI, fidaxomicin reduces recurrent infections. Treating an initial CDI with fidaxomicin instead of vancomycin prevents one additional recurrence at four weeks for every 10 patients treated (number needed to treat [NNT] = 10; 95% CI, 7 to 18). Treating recurrent CDI with fidaxomicin reduces recurrence at 30 days with an NNT of 7 (95% CI, 4 to 30) and at 90 days with an NNT of 5 (95% CI, 3 to 112) compared with vancomycin.
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