Treatment of pediatric Clostridium difficile infection: a review on treatment efficacy and economic value

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2017
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Abstract
Treatment of pediatric Clostridium difficile infection: a review on treatment efficacy and economic value Amanda R D’Ostroph,1 Tsz-Yin So2 1UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, 2Department of Pharmacy, Moses H Cone Memorial Hospital, Greensboro, NC, USA Abstract: The incidence of Clostridium difficile infection (CDI) in pediatric patients continues to rise. Most of the pediatric recommendations for CDI treatment are extrapolated from the literature and guidelines for adults. The American Academy of Pediatrics recommends oral metronidazole as the first-line treatment option for an initial CDI and the first recurrence if they are mild to moderate in severity. Oral vancomycin is recommended to be used for severe CDI and the second recurrent infection. Additional pulsed regimen of oral vancomycin, which is tapered, may increase efficacy in refractory patients. However, there is lack of large studies evaluating the use of fidaxomicin in pediatrics to know whether it could be a safe and effective treatment option for difficult-to-treat patients. Fidaxomicin is associated with higher total drug costs compared to metronidazole and vancomycin, but the literature supports its use due to a lower rate of CDI recurrence, which may result in cost savings. Further studies are warranted to evaluate the use of fidaxomicin in patients <18 years old and to understand its role in the standard of care for pediatric patients with CDI. Keywords: Clostridium difficile, diarrhea, fidaxomicin, vancomycin, metronidazole, pediatrics 
Reference Key
amanda2017treatmentinfection Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Amanda R D'Ostroph;Tsz-Yin So and
Journal Infection and drug resistance
Year 2017
DOI
10.2147/IDR.S119571
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