Jason Gallagher, PharmD: Treating C Difficile Infections

Fecal microbiota transplantation could be crucial in the coming years in treating C difficile infections.

Fidaxomicin and vancomycin are 2 of the most commonly used and effective treatments for Clostridioides difficile infections (CDI), but cost can be a major factor in preventing more widescale use.

In an interview with ContagionLive®, Jason Gallagher, PharmD, FCCP, FIDP, FIDSA, BCPS Clinical Professor at Temple University School of Pharmacy and Clinical Pharmacy Specialist in Infectious Diseases at Temple University Hospital, said fidaxomicin was the top of the line option for patients with CDI because it results in less relapse.

“Fidaxomicin is more expensive, vancomycin costs have come down with different formulations,” Gallagher said. “But truthfully I don’t think there is any debate over what the best drug is and that is fidaxomicin.”

Gallagher, who is the Editor-in-Chief of Contagion, also said fecal microbiota transplantation could be a highly utilized procedure for C difficile patients.

This treatment is mainly effective because patients with recurrent CDI generally have less biodiversity in their colons than healthy individuals. However, the transplantation takes advantage of this fact to better increase the biodiversity in the gut.

Gallagher said there is some unknown for this therapy and investigators and stakeholders are beginning to explore just how fecal microbiota transplantation should be standardized and utilized for patients with CDI.