What is fidaxomicin? New options for macrolide antibiotics

Fidaxomicin (English name: fidaxomicin, trade name: Dificid) is a macrolide antibiotic developed by Optimer Company in 2011 It was approved for sale by the USFDA on May on May 27. It is an important drug of choice for the treatment of Clostridium difficile-associated diarrhea (CDAD).

Fidaxomicin selectively eradicates pathogenic Clostridium difficile (Clostridium difficile) by inhibiting bacterial RNA polymerase, thereby blocking the bacterial transcription process. This mechanism allows fidaxomicin to effectively treat diarrhea caused by Clostridium difficile while causing less damage to the normal intestinal flora.

Fidaxomicin is mainly used to treat mild to moderate diarrhea caused by Clostridium difficile, especially in refractory or recurrent cases. It is suitable for adult and pediatric patients 6 months and older. For adults and pediatric patients who weigh at least 12.5kg and are able to swallow tablets, the recommended dose is 200 mg taken orally twice daily for 10 days. Medications should be swallowed whole and should not be chewed or broken.

Fidaxomicin is excellent in treating Clostridium difficile -associated diarrhea. Clinical trials have shown that its cure rate is comparable to oral vancomycin, but is superior to vancomycin in reducing recurrence rates and improving overall cure rates. The incidence of adverse reactions is low, and most of them are mild symptoms, such as nausea, vomiting, abdominal pain, diarrhea, etc. Serious adverse reactions are rare, but if symptoms such as allergic reactions occur, you need to stop taking the medication immediately and seek medical advice.

Compared with traditional antibiotics, fidaxomicin is highly specific against Clostridium difficile and can effectively kill or inhibit the growth of this bacteria while causing less damage to the normal intestinal flora.

Fidaxomicin and its major metaboliteOP-1118 are substrates of the efflux transporter P-glycoprotein (P-gp) expressed in the gastrointestinal tract. When fidaxomicin is coadministered with P-gp inhibitors such as cyclosporine, it may result in a significant increase in the plasma concentrations of fidaxomicin and OP-1118. While this increase remains within safe limits, patients should consult their physician when taking the combination.

Reference materials:https://en.wikipedia.org/wiki/Fidaxomicin

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