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Fidaxomicin
- ✅ Fidaxomicin is an oral macrocyclic antibiotic used in the management of Clostridioides difficile infection (CDI).
- 📌 Its use is reserved for severe or recurrent CDI due to high cost and stewardship considerations.
- 📚 Always confirm dosing with the BNF or local antimicrobial guidelines.
⚙️ Mode of Action
- 🔬 Fidaxomicin inhibits the bacterial enzyme RNA polymerase, blocking transcription and protein synthesis.
- 🌍 It is poorly absorbed systemically, achieving high concentrations in the gut lumen — ideal for treating colonic infection.
- 💊 Narrow spectrum — primarily active against C. difficile, sparing most of the normal gut flora.
📊 Dose Range (BNF confirmation required)
| Name | Starting Dose | Frequency | Route |
|---|---|---|---|
| Fidaxomicin (for severe or recurrent C. difficile infection) | 200 mg | BD | PO for 10 days |
🔄 Interactions
- 📌 See BNF — minimal systemic absorption, so fewer interactions than other antibiotics.
⚠️ Cautions
- 📌 See BNF. Generally well tolerated, but data in pregnancy, children, and severe hepatic impairment are limited.
⛔ Contraindications
- 📌 See BNF. Standard cautions for allergy/hypersensitivity apply.
💥 Side Effects
- 😣 Constipation
- 🤢 Nausea and vomiting
- 💩 Abdominal pain, bloating (less common)
- 🧪 Rare: anaemia, neutropenia, elevated liver enzymes
📚 References
📝 Revision Notes
- 🎯 Think of fidaxomicin when metronidazole or vancomycin fail, or in recurrent CDI cases.
- 💡 Advantage: less disruption of gut microbiome → lower recurrence rates compared to vancomycin.
- ⚖️ Limiting factor: cost — restricted by antimicrobial stewardship policies in UK practice.
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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