{
  "abstract": "Background and Importance Clostridioides difficile is the leading cause of nosocomial diarrhoea, with an increasing incidence in community settings. The infection is strongly associated with prior antibiotic exposure, particularly in hospitalised patients or those with significant comorbidities.Aim and Objectives To describe the use of fidaxomicin in a tertiary care hospital, analysing its utilisation pattern, patient characteristics, and clinical outcomes.Material and Methods An observational, descriptive, retrospective, single-centre study was conducted. All patients with a microbiological sample positive for Clostridioides difficile toxin treated with fidaxomicin between January 2024 and February 2025 were included. Collected variables included demographics, received treatments (vancomycin and fidaxomicin), C. difficile-related hospital admissions, recurrences, prior antibiotic exposure, fidaxomicin units consumed, and associated cost (MFP). Data were obtained from the electronic medical record and the electronic prescribing system of the hospital. A descriptive statistical analysis was performed, expressing quantitative variables as median and range, and qualitative variables as absolute and relative frequencies (%).Results Seventy-five patients were included, with a median age of 65 years (range 2–89); 62.7% were male. Previous oral vancomycin treatment was recorded in 66.7% of cases, and all patients received oral fidaxomicin (62.7% standard 10-day regimen, 37.3% extended regimen). 84% had received systemic antibiotics in the 12 months prior to fidaxomicin administration, with a median of three courses. The most frequent antibiotic classes were cephalosporins and carbapenems (56%), penicillins and fluoroquinolones (45%), glycopeptides (24%), and oxazolidinones or sulfonamides (13%). Fidaxomicin was used for mild primary infection in 20 cases, severe primary infection in 28, first recurrence in 20, and second or later recurrences in 7. Only six patients (8%) experienced recurrence within one year, and sixteen (21.3%) required hospitalisation. A total of 1,570 units of fidaxomicin were used, with an estimated cost of €114,316.Conclusion and Relevance Fidaxomicin has become a preferred therapeutic option over vancomycin for Clostridioides difficile infection, particularly in patients at high risk of recurrence. Despite its higher direct cost, the reduction in recurrences and hospital admissions may translate into an overall clinical and economic benefit. These findings support the implementation of evidence-based pharmacotherapeutic protocols and an individualised treatment selection.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Hospital Regional Universitario De Málaga, Pharmacy Service, Malaga, Spain"
      ],
      "name": "M Molina Guerrero"
    },
    {
      "affiliations": [
        "Hospital Regional Universitario De Málaga, Pharmacy Service, Malaga, Spain"
      ],
      "name": "M Florit Sanchez"
    },
    {
      "affiliations": [
        "Hospital Regional Universitario De Málaga, Pharmacy Service, Málaga, Spain"
      ],
      "name": "M Rouco Blanco Rajoy"
    },
    {
      "affiliations": [
        "Hospital Regional Universitario De Málaga, Pharmacy Service, Malaga, Spain"
      ],
      "name": "C Gallego Fernandez"
    },
    {
      "affiliations": [
        "Hospital Regional Universitario De Málaga, Pharmacy Service, Malaga, Spain"
      ],
      "name": "R Asensi Diez"
    }
  ],
  "title": "4CPS-285 Description and follow-up of the use of fidaxomicin in a tertiary care hospital",
  "uid": "02624fcd-6662-5d88-8e4d-e7e6f6c209c2"
}