Recurrent Clostridium difficile colitis in elderly: the role of fidaxomicin

Abstract

Clostridium difficile colitis is a substantial cause of in-hospital morbidity. Since the mortality attributable may be as high as 10%, a prompt and effective treatment is advisable. Fidaxomicin is a well-documented effective drug for the treatment of C. difficile colitis and it is particularly effective in the treatment of recurrences. We report a case of a 92-year-old woman with prolonged hospitalization and recurrent episodes (three in a three-month period) of C. difficile diarrhea. Each episode initially responded to vancomycin. However, after the third episode fidaxomicin was given, with a sustained response (5 months without further episodes). In this patient fidaxomicin was safe and effective in treating recurrence of C. difficile colitis. The use of fidaxomicin as a therapy of first episode of C. difficile colitis should be considered for those patients with a predictable high risk of recurrent C. difficile colitis.