Clinical and economic outcomes associated with fidaxomicin in comparison to vancomycin, metronidazole, and FMT: A systematic literature review
2024

Comparing Fidaxomicin to Other Treatments for Clostridioides difficile Infection

Sample size: 79 publication 10 minutes Evidence: moderate

Author Information

Author(s): Li Qinghua, Obi Engels, Marciniak Anne, Newman Rebecca, Whittle Isabelle, Kufakwaro Jason

Primary Institution: Merck & Co., Inc.

Hypothesis

This systematic literature review aimed to explore clinical and economic outcomes associated with fidaxomicin use with or without comparison to vancomycin, metronidazole, or fecal microbiota transplantation (FMT).

Conclusion

Fidaxomicin was clinically effective compared to vancomycin and is often reported as cost-effective, especially in high-risk subpopulations.

Supporting Evidence

  • Fidaxomicin showed higher sustained clinical cure rates compared to vancomycin at 30 and 60 days follow-up.
  • Lower recurrence rates were reported post-fidaxomicin treatment compared to vancomycin.
  • Fidaxomicin was cost-effective in 14 of 21 economic analyses.

Takeaway

Fidaxomicin is a medicine that helps people with a bad stomach infection called CDI, and it works better than some other medicines while also saving money in the long run.

Methodology

The study involved a systematic literature review and meta-analysis of 79 publications, focusing on clinical and economic outcomes of fidaxomicin compared to other treatments.

Potential Biases

Some studies were assessed to be at high-risk of bias, particularly those with open-label designs.

Limitations

The study faced limitations due to heterogeneity in outcome definitions and follow-up periods across included studies.

Participant Demographics

The review included studies with adult patients, with some studies also reporting outcomes in pediatric populations.

Statistical Information

P-Value

0.0007

Confidence Interval

95% CI: 1.8–8.4

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1097/MD.0000000000039219

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