title: [Antimicrobial therapy of Clostridium difficile infection. Systematic review and meta-analysis of the scientific evidence].
abstract: BACKGROUND
  Clostridium difficile is the leading cause of antibiotic associated infectious nosocomial diarrhoea. Limited number of new pharmaceutical products have been developed and registered in the past decades for the treatment of Clostridium difficile infection. The available scientific evidence is limited and hardly comparable.
  
  
  OBJECTIVE
  To analyse the clinical efficacy and safety of metronidazole, vancomycin and fidaxomicin in the therapy of Clostridium difficile infection.
  
  
  METHODS
  Systematic review and meta-analysis of the literature data.
  
  
  RESULTS
  Meta-analysis of literature data showed no significant difference between these antibiotics in clinical cure endpoint (odss ratios: fidaxomicin vs. vancomycin 1.19; vancomycin vs. metronidazol 1.69 and fidaxomicin vs. metronidazol 2.00). However, fidaxomicin therapy was significantly more effective than vancomicin and metronidazol in endpoints of recurrence and global cure (odds ratios: fidaxomicin vs. vancomycin 0.47; vancomycin vs. metronidazol 0.91 és fidaxomicin vs. metronidazol 0.43). There was no significant difference between fidaxomicin, vancomycin and metronidazole in safety endpoints.
  
  
  CONCLUSIONS
  Each antibiotic similarly improved clinical cure. Fidaxomicin was the most effective therapeutic alternative in lowering the rate of recurrent Clostridium difficile infections.
authors.affiliation: Budapesti Corvinus Egyetem Egészség-gazdaságtani és Egészségügyi Technológiaelemzési Kutatóközpont, Budapest, Fővám tér 8. 1093. valentin.brodszky@uni-corvinus.hu
authors.forename: Valentin
authors.initials: V
authors.lastname: Brodszky
authors.forename: László
authors.initials: L
authors.lastname: Gulácsi
authors.forename: Endre
authors.initials: E
authors.lastname: Ludwig
authors.forename: Gyula
authors.initials: G
authors.lastname: Prinz
authors.forename: János
authors.initials: J
authors.lastname: Banai
authors.forename: Péter
authors.initials: P
authors.lastname: Reményi
authors.forename: Bálint
authors.initials: B
authors.lastname: Strbák
authors.forename: Adrienne
authors.initials: A
authors.lastname: Kertész
authors.forename: Irén
authors.initials: I
authors.lastname: Kopcsóné Németh
authors.forename: Edit
authors.initials: E
authors.lastname: Zsoldiné Urbán
authors.forename: Petra
authors.initials: P
authors.lastname: Baji
authors.forename: Márta
authors.initials: M
authors.lastname: Péntek
mesh_terms: D000617:Aminoglycosides / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016360:Clostridioides difficile / Q000187:drug effects; D003428:Cross Infection / Q000188:drug therapy* / Q000382:microbiology*; D003967:Diarrhea / Q000188:drug therapy / Q000382:microbiology*; D004761:Enterocolitis, Pseudomembranous / Q000188:drug therapy* / Q000209:etiology; D000077732:Fidaxomicin; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use; D016896:Treatment Outcome; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D008795:Metronidazole; D014640:Vancomycin; D000077732:Fidaxomicin