Fidaxomicin for Clostridium difficile Infection.

نویسندگان

  • Nasia Safdar
  • William A Craig
چکیده

To the Editor: In their randomized study comparing fidaxomicin with vancomycin for Clostridium difficile infection, Louie et al. (Feb. 3 issue)1 found that substantially fewer patients in the fidaxomicin group had recurrences of C. difficile infection within 4 weeks after the conclusion of treatment. We recently reported on an observational study involving U.S. veterans in which the recurrence of C. difficile infection within 90 days was significantly reduced in patients who did not receive proton-pump inhibitors (PPIs) as compared with those who received PPIs concurrent with treatment for C. difficile infection, independent of the treatment regimen for C. difficile infection.2 Other observational studies have shown associations of PPI use with an increased risk of recurrent C. difficile infection3 and use of gastric acid suppressants with an increased risk of recurrent pseudomembranous colitis.4 In the trial reported on by Louie et al., we expect that randomization effectively equalized the distribution of PPI users between treatment groups, but it would be of interest and potential clinical importance to know whether there were any betweengroup differences in PPI use and whether the investigators found any potential effect modification between PPI use and either antibiotic treatment regimen for C. difficile infection on the rate of recurrent C. difficile infection.

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عنوان ژورنال:
  • The New England journal of medicine

دوره 364 19  شماره 

صفحات  -

تاریخ انتشار 2011