CLOSTRIDIOIDES DIFFICILE – SPECIFIC AGENTS

They only treat Clostridioides difficile infections. Fidaxomicin is a nonabsorbed macrocyclic antibiotic with a narrow spectrum that is ideal for treating infections caused by C difficile because it is sparing to the normal flora of the GI tract, allowing it to be restored during therapy.

Developed specificially to clostriduim deficille – neutrulizes the toxins – Umab = Antibody for drugs – Best used together

Mehanism of action:

  1. Fidaxomicin is a ribosomal protein synthesis inhibitor that is bactericidal. It is classified as a macrolide , but unlike other macrolides, it is not absorbed in the GI tract and is able to kill susceptible organisms.

  2. Bezlotoxumab is a monoclonal antibody that binds to toxin B produced by C difficile inactive, decreasing the risk of recurrent infections.

Side effects:

  1. Nausea, diarrhea, abdominal pain, and cramping.

  2. Since bezlotoxumab only binds toxins and does not kill C difficile directly; patients need to receive anti-bacterials that are treating C difficile as well (e.g., vancomycin or fidaxomicin).

  3. Bezlotoxumab can be given at any time during the treatment course, with a similar reduction in recurrence.