02.19.2021 - By Society of Infectious Diseases Pharmacists
Dr. Kevin Garey (@GareyKgarey), Dr. Kelly Reveles (@KellyReveles), Dr. Mandelin Cooper, and host Dr. Rachel Britt (@RachelBPharmD) discuss proposed updates of the IDSA-SHEA C. difficile guidelines, including: fidaxomicin over oral vancomycin as first-line therapy, the roles and logistical hurdles of fecal microbiota transplant, bezlotoxumab, and the pros and cons of prophylaxis.
Timestamps
1:16 - Panel introductions
3:19 - Fidaxomicin vs PO vancomycin for first occurrence
7:21 - Fidaxomicin cost effectiveness
11:26 - Factors to consider for health systems when considering switch to fidaxomicin
14:23 - Fidaxomicin vs PO vancomycin for recurrences
17:52 - Role of pulsed and tapered PO vancomycin
19:57 - Role of fecal microbiota transplant (FMT)
22:24 - Challenges of FMT and where pharmacy fits in
27:27 - Bezlotoxumab
31:54 - Feasibility issues with bezlotoxumab and strategies to address them
35:25 - CDI prophylaxis
40:28 - Stewardship's role in reducing C. difficile infections
References
Fidaxomicin Cost-effectiveness
Reveles KR, et al. Pharmacotherapy. 2017;37(12):1489-97.
Watt M, et al. Infection. 2016;44(5):599-606.
Cornely OA, et al. J Antimicrob Chemother. 2018;73(9):2529-39.
Rubio-Terres C, et al. Eur J Clin Microbiol Infect Dis. 2019;38(6):1105-11.
Bezlotoxumab
Wilcox MH, et al. N Engl J Med. 2017;376:305-17.
Oksi J, et al. Eur J Clin Microbiol Infect Dis. 2019;38(10):1947-52.
Hengel RL, et al. Open Forum Infect Dis. 2020;7(4):ofaa097.
Bezlotoxumab Cost-effectiveness
Salavert M, et al. Adv Ther. 2018;35(11):1920-34.
Prabhu VS, et al. Clin Infect Dis. 2018;66(3):355-62.
Primary prophylaxis
Pereiras MA, et al. Biol Blood Marrow Transplant. 2017; 23:S395.
Ganetsky A, et al. Clin Infect Dis. 2019;68(12):2003-2009.
Mullane KM, et al. Clin Infect Dis. 2019; 68(2):196–203.
Secondary prophylaxis
Carignan A, et al. Am J Gastroenterol. 2016;111:1834-1840.
Van Hise NW, et al. Clin Infect Dis. 2016;63:651-653.
Splinter et al. Ann Pharmacother. 2018;52:113-119.
Knight EM, et al. J Pharm Pract. 2019;:897190019825994.
Morrisette T, et al. Biol Blood Marrow Transplant. 2019;25(10):2091-2097.