Pharmacologic class: Macrolide
Therapeutic class: Anti-infective
Pregnancy risk category B
Bactericidal against Clostridium difficile in vitro, inhibiting RNA synthesis by RNA polymerases
Tablets: 200 mg
Indications and dosages
➣ C. difficile-associated diarrhea
Adults: 200-mg tablet P.O. b.i.d. for 10 days
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).
• 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.
GI: nausea, vomiting, abdominal pain, GI hemorrhage
Hematologic: anemia, neutropenia
Drug-drug. Cyclosporine: increased plasma concentrations of fidaxomicin and its metabolite
• Monitor CBC periodically.
• Observe patient for signs and symptoms of GI hemorrhage.
• 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.
ClassificationTherapeutic: anti infectives
Adverse Reactions/Side Effects
- GI hemorrhage (life-threatening)
- nausea (most frequent)
- abdominal pain
- hypersensitivity reactions (life-threatening)
Drug-Drug interactionNo significant interactions noted.
- 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 DiagnosesRisk for infection (Indications)
- Oral: Administer twice daily without regard to food.
- 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.
- Decrease in diarrhea caused by Clostridium difficile.