fidaxomicin
fidaxomicin
Pharmacologic class: Macrolide
Therapeutic class: Anti-infective
Pregnancy risk category B
Action
Bactericidal against Clostridium difficile in vitro, inhibiting RNA synthesis by RNA polymerases
Availability
Tablets: 200 mg
Indications and dosages
➣ C. difficile-associated diarrhea
Adults: 200-mg tablet P.O. b.i.d. for 10 days
Contraindications
None
Precautions
Use cautiously in:
• systemic infections or absence of proven or strongly suspected C. difficile infection
• pregnant or breastfeeding patients
• children younger than age 18 (safety and efficacy not established).
Administration
• Administer with or without food.
• Be aware that using drug in absence of proven or strongly suspected C. difficile infection is unlikely to provide benefit to patient and increases risk of development of drug-resistant bacteria.
• Be aware that drug has minimal systemic absorption and isn't effective in treatment of systemic infections.

Adverse reactions
GI: nausea, vomiting, abdominal pain, GI hemorrhage
Hematologic: anemia, neutropenia
Interactions
Drug-drug. Cyclosporine: increased plasma concentrations of fidaxomicin and its metabolite
Patient monitoring
• Monitor CBC periodically.
• Observe patient for signs and symptoms of GI hemorrhage.
Patient teaching
• Tell patient to take drug with or without food.
• Inform patient that drug only treats C. difficile-associated diarrhea and shouldn't be used to treat other infections.
• Inform patient that although it's common to feel better early in the course of therapy, the drug should be taken exactly as directed. Skipping doses or not completing full course of therapy may decrease effectiveness of immediate treatment and increase likelihood that bacteria will develop resistance and won't be treatable by this drug or other antibacterials in the future.
☞ Instruct patient to promptly report signs and symptoms of GI bleeding.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs mentioned above.
fidaxomicin
(fi-dax-oh-mye-sin) ,Dificid
(trade name)Classification
Therapeutic: anti infectivesPharmacologic: macrolides
Indications
Action
Therapeutic effects
Pharmacokinetics
Time/action profile
ROUTE | ONSET | PEAK | DURATION |
---|---|---|---|
PO | unknown | unknown | unknown |
Contraindications/Precautions
Adverse Reactions/Side Effects
Gastrointestinal
- GI hemorrhage (life-threatening)
- nausea (most frequent)
- abdominal pain
Hematologic
- anemia
- neutropenia
Miscellaneous
- hypersensitivity reactions (life-threatening)
Interactions
Drug-Drug interaction
No significant interactions noted.Route/Dosage
Availability
Nursing implications
Nursing assessment
- Monitor bowel function for diarrhea, abdominal cramping, fever, and bloody stools. May begin up to several weeks following cessation of antibiotic therapy.
- Monitor for signs and symptoms of hypersensitivity reactions (dyspnea, pruritus, rash, angioedema of mouth, throat, and face) periodically during therapy. Risk increases with a macrolide allergy.
- Lab Test Considerations: May cause ↑ serum alkaline phosphatase, and hepatic enzymes.
- May cause ↓ serum bicarbonate, ↓ platelet count, anemia, and neutropenia.
- May cause hyperglycemia and metabolic acidosis.
Potential Nursing Diagnoses
Risk for infection (Indications)Diarrhea (Indications)
Implementation
- Oral: Administer twice daily without regard to food.
Patient/Family Teaching
- Instruct patient to take fidamoxicin as directed for the full course of therapy, even if feeling better. Skipping doses or not completing full course of therapy may decrease effectiveness of therapy and increase risk that bacteria will develop resistance and not be treatable in the future.
- Advise female patients to notify health care professional if pregnancy is planned or suspected or if breast feeding.
Evaluation/Desired Outcomes
- Decrease in diarrhea caused by Clostridium difficile.