Fidaxomicin or Vancomycin for Patients Receiving Concomitant Antibiotics?

Patients with Clostridioides difficile infection (CDI) who are receiving concomitant antibiotics (CA) for a different infection are at excess risk for treatment failure and recurrent CDI. To test if fidaxomicin is more efficacious than vancomycin for such patients, investigators conducted a study supported by the manufacturer of fidaxomicin. Participants were randomized to receive fidaxomicin (74 patients; 46% male, 69% younger than 65) or vancomycin (70 patients; 50% male, 57% younger than 65) and the proportions achieving clinical cure were assessed in the two groups.

The between-group difference in clinical cure at the end of therapy was not significant: 73% (fidaxomicin) and 63% (vancomycin). Duration of hospital stay (5 and 6 days), rec…