Standard Treatment

2021 First Line Therapy – Fidaxomicin
- 2017 IDSA Guidelines
- Oral vancomycin as 1st line therapy
- 2021 IDSA Guidelines
- Fidaxomicin 1st → oral vancomycin an acceptable alternative
- Similar initial clinical response
- Proposed Benefits of Fidaxomicin:
- Limited documented resistance
- Used solely for CDI
- Ease of dosing
- Sustained response?
Conditional Recommendation
Moderate Certainty of Evidence
Fidaxomicin in the Literature

Literature Summary

Hesitancy with Fidaxomicin?
- Cost and Resource Allocation
- Fidaxomicin remains rough 4x more expensive than oral vancomycin
- Oral vancomycin remains expensive
- Lack of insurance or lack of insurance coverage
- Unlikely to be able to afford fidaxomicin if no insurance
- Many insurance companies still requiring prior authorization for fidaxomicin
- Fidaxomicin remains rough 4x more expensive than oral vancomycin
- Limited number of cost-effectiveness studies – is the juice worth the squeeze?
- IDSA guidelines place high emphasis on potential clinical benefit
Treatment Summary
