fidaxomicin

General

Pronunciation
fi-dax-oh-MYE-sin

Trade Name(s)

• Dificid

Pregnancy Category
Category B

Ther. class.
anti-infectives

Pharm. class.
macrolides

Indications

Treatment of diarrhea associated with Clostridium difficile .

Action

• Bactericial action mostly against clostridia; inhibits RNA synthesis.

• Acts locally in the GI tract to eliminate Clostridium difficile .

Therapeutic Effect(s):
Elimination of diarrhea caused by Clostridium difficile .

Pharmacokinetics

Absorption: Minimal systemic absorption.

Distribution: Stays primarily in the GI tract.

Metabolism and Excretion: Mostly transformed via hydrolysis in the GI tract to OP-1118, its active metabolite. Eliminated mostly (>92%) in fece: <1% excreted in urine.

Half-life: Fidaxomicin—11.7 hr; OP-1118—11.2 hr.

TIME/ACTION PROFILE

ROUTE	ONSET	PEAK	DURATION
PO	unknown	unknown	unknown

Contraindication/Precautions

Contraindicated in:
None noted.

Use Cautiously in:

• OB: Lactation: Use during pregnancy only if clearly needed, use cautiously during lactation;

• Pedi: Safe and effective use in children <18 yr has not been established.

Adverse Reactions/Side Effects

GI: GI HEMORRHAGE, nausea, abdominal pain.

Hemat: anemia, neutropenia.

*CAPITALS indicates life-threatening.
*italic indicates most frequent.

Interactions

Drug-Drug
No significant interactions noted.

Route/Dosage

• PO (Adults >18 yr): 200 mg twice daily for 10 days..

Availability

• Tablets: 200 mg

Assessment

• Monitor bowel function for diarrhea, abdominal cramping, fever, and bloody stools. May begin up to several weeks following cessation of antibiotic therapy.

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

PO: 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 breastfeeding.

Evaluation/Desired Outcomes

Decrease in diarrhea caused by Clostridium difficile .