Recommendations from a panel of experts on the usefulness of fidaxomicin for the treatment of infections caused by Clostridium difficile
Por:
Bouza, E, Cobo, J, Almirante, B, Duenas, C, Escudero, R, Farinas, C, Feher, C, Horcajada, J, Merino, E, Merino, P, Montejo, M, Olmedo, M, Ramos-Martinez, A, Rodriguez-Pardo, D, Mesa, J, Salavert, M, Sarria, C, Silva, J and Grp Trabajo CLODIEXPAN
Publicada:
1 feb 2019
Resumen:
Introduction. Clostridium difficile infections have a high recurrence rate, which can complicate the prognosis of affected patients. It is therefore important to establish an early detection and an appropriate therapeutic strategy. The objective of this manuscript was to gather the opinion of an expert group about the predictive factors of poor progression, as well as when to use fidaxomicin in different groups of high-risk patients.
Methods. A scientific committee of three experts in infectious diseases reviewed the most recent literature on the management of C. difficile infections, and the use of fidaxomicin. They developed a questionnaire of 23 items for consensus by 15 specialists in this type of infection using a modified Delphi method.
Results. The consensus reached by the panelists was 91.3% in terms of agreement. The most important agreements were: recurrence is a risk criterion per se; fidaxomicin is effective and safe for the treatment of infections caused by C. difficile in critical patients, immunosuppressed patients, or patients with chronic renal failure; fidaxomicin is recommended from the first episode of infection to ensure maximum efficacy in patients with well-contrasted recurrence risk factors.
Conclusions. The experts consulted showed a high degree of agreement on topics related to the selection of patients with poorer prognosis, as well as on the use of fidaxomicin in groups of high-risk patients, either in the first line or in situations of recurrence.
Filiaciones:
Bouza, E:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Cobo, J:
Hosp Univ Ramon y Cajal, IRYCIS, Serv Enfermedades Infecciosas, Madrid, Spain
Almirante, B:
Hosp Univ Vall dHebron, Serv Enfermedades Infecciosas, Passeig Vall dHebron 119-129, Barcelona 08035, Spain
Duenas, C:
Hosp Clin Univ Valladolid, Valladolid, Spain
Escudero, R:
Hosp Univ Ramon y Cajal, Madrid, Spain
Farinas, C:
Univ Cantabria, Hosp Univ Marques de Valdecilla, Santander, Spain
Feher, C:
Hosp Clin Barcelona, Barcelona, Spain
Horcajada, J:
Hosp Mar, Barcelona, Spain
:
Hosp Gen Univ Alicante, Alicante, Spain
Merino, P:
Hosp Clin San Carlos, Madrid, Spain
Montejo, M:
Hosp Univ Cruces, Baracaldo, Spain
Olmedo, M:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Ramos-Martinez, A:
Hosp Univ Puerta de Hierro Majadahonda, Madrid, Spain
Rodriguez-Pardo, D:
Hosp Univ Vall dHebron, Barcelona, Spain
Mesa, J:
Hosp Reg Univ Carlos Haya, Malaga, Spain
Salavert, M:
Hosp Univ & Politecn La Fe, Valencia, Spain
Sarria, C:
Hosp Univ La Princesa, Madrid, Spain
Silva, J:
Hosp Univ 12 Octubre, Madrid, Spain
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