New antibiotic recommended for severe CDI

Clostridium-difficile_456px A new first-in-class antibiotic has been recommended in the UK for treatment of severe Clostridium difficile infection (CDI).

New guidance from Public Health England recommends Dificlir (fidoxamicin) from Astellas for adults with severe CDI and high risk of recurrence, or for recurrent CDI.

This makes the drug available for those CDI patients who are at highest risk, including those with multiple conditions.

CDI, a bacterial infection, is predominantly hospital-acquired and is potentially fatal, with 27,000 cases in the UK each year leading to 3,000 deaths.

In clinical trials, Dificlir showed similar efficacy and safety to the current standard treatment, vancomycin, but more than halved the rate of recurrence.

Recurrence of CDI is the greatest problem encountered in treatment of the infection, occurring in up to 25% of patients within 30 days of treatment.

The NHS has identified CDI control as a key aspect of patient safety, with targets for reduction in cases that may be enforced by financial penalties.

The targets demand a reduction in CDI infections over 2013/2014 of 30% (on average) for acute trusts and 21% (on average) for CCGs.

Dr Simon Goldenberg, consultant microbiologist, said the new guidance was “a huge step forward in being able to improve the overall management of CDI,” offering a “very welcome” opportunity to “bring down rates of infection”.

Graziella Kontkowski, founder of the patient group C-diff Support, noted that while CDI rates have fallen in hospitals they have risen in the community. She described the new guidance as “good news for patients” that “will encourage a more rigorous approach to reducing both new and recurrent cases of the infection.”