fidaxomicin and Shock--Septic

To report the successful use of crushed fidaxomicin via a nasogastric tube for treatment of a severe Clostridium difficile infection in a critically ill patient.. Clinical observation of a patient, images of abdominal computed tomography, antimicrobial therapy and course of infection parameters.. Relevant information contained in the medical observation of the patient and selection of image and laboratory parameters performed in the patient.. We report a case of a 79-year old patient who developed septic shock with an increasing need for norepinephrine and acute renal failure due to a severe Clostridium difficile infection. Antimicrobial therapy with vancomycin via a nasogastric tube and metronidazole i.v. did not lead to improvement, infection parameters further increased, and the clinical condition became increasingly impaired. After 10 days, antimicrobial therapy was changed to fidaxomicin, crushed and administered via nasogastric tube. Within 24hours, infection parameters decreased. Further diarrhoea ceased and stool samples were negative for Clostridium difficile antigen.. Our case confirms that administration of fidaxomicin via a nasogastric tube was safe and effective in this patient. Further studies are needed to evaluate the efficacy of this strategy in critically ill patients systematically.

Topics: Aged; Aminoglycosides; Anti-Bacterial Agents; Clostridioides difficile; Critical Illness; Diarrhea; Enterocolitis, Pseudomembranous; Female; Fidaxomicin; Humans; Intubation, Gastrointestinal; Shock, Septic; Treatment Outcome

Topics: Aged; Aminoglycosides; Anti-Bacterial Agents; Carcinoma, Squamous Cell; Clostridioides difficile; Critical Care; Cross Infection; Enterocolitis, Pseudomembranous; Female; Fidaxomicin; Humans; Intubation, Gastrointestinal; Mandibular Neoplasms; Mouth Neoplasms; Necrosis; Shock, Septic