Background Nowadays, Clostridium difficile infection (CDI) is the leading cause of nosocomial diarrhoea in industrialised countries and the incidence is increasing.
Purpose To examine whether fidaxomicin prescribing was following the Pharmacy Committee criteria.
Material and methods This was a retrospective observational study carried out over one year. Fidaxomicin prescribing was considered appropriate in the following cases: when the first recurrence had previously been treated with vancomycin and there was a high risk of recurrence (considered in the presence of at least two of these factors: age >65 years, serious underlying disease, concomitant use of antimicrobials) and if the recurrence was severe (10 or more loose stools or fever >38.5°C or leukocyte count >15,000/mm3 or a rise in serum creatinine >1.5 times above the baseline) and if it had a clinical impact (the persistence of the disarrhoea endangered the health of the patient worsening the underlying disease and/or increasing the length of hospital stay); in second or subsequent recurrences after considering the risk or severity of recurrences and their clinical impact.
Results A total of eight prescriptions were written for six patients. 25% did not comply with the approved criteria. The median age was 53 years (range: 41–83). When prescriptions were appropriate (75%), all cases presented severe underlying disease and a recurrence with clinical impact; 66.7% were prescribed as treatment for first recurrence and 75% of the patients were already receiving antimicrobial treatment. Regarding the severity of the recurrence, leucocytosis was found in 50% of cases, ten or more loose stools in 25% of cases and a rise of serum creatinine in 25%. 12.5% of patients had recurrences after being treated with fidaxomicin. 87.5% of these prescriptions were supervised by the Infectious Disease Unit (IDU).
Conclusion Since fidaxomicin has been introduced into the hospital, there have been few prescriptions for this drug. Most prescriptions were appropriately and accurately prescribed under IDU supervision.
References and/or acknowledgements No conflict of interest.
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