Fidaxomicin：擺脫困難梭狀芽孢桿菌感染復發的新武器

Fidaxomicin: A New Drug that Can Decrease Recurrence of Clostridium difficile Infection

謝旻翰(Min-Han Hsieh) ； 陳彥旭(Yen-Hsu Chen)

《內科學誌》 24卷3期 (2013/06) Pp. 198-204

https://doi.org/10.6314/JIMT.2013.24(3).05

摘要

困難梭狀芽孢桿菌（Clostridium difficile）感染是常見的院內感染性腹瀉。近年來，不論是在歐美國家或是台灣，C. difficile感染的情形均逐漸增加。對於C. difficile感染的治療，傳統上是以口服的硝基甲嘧唑乙醇（metronidazole）或萬古鰴素（vancomycin）為首選用藥，然而其高復發率卻是臨床上治療的難處。自2011 年5 月起，美國食品藥物管理局核准一個用來治療C. difficile感染的新藥—fidaxomicin 。Fidaxomicin是新一類的抗生素，屬大環結構（macrocyclic peptide）；抗菌範圍較窄效，只對革蘭氏陽性菌有效，特別是C. difficile。故使用上，不會影響正常的腸道菌叢之生長。根據現有的臨床試驗結果發現，fidaxomicin在治療C. difficile感染治癒率和vancomycin相當，而兩者的副作用也相當，但卻有較低的復發率。然而，除C. difficile感染外，目前其他臨床應用的研究還不多，期待未來有更多的研究，可以支持其在治療C. difficile感染以外的角色。

關鍵字

困難梭狀芽孢桿菌

並列摘要

Clostridium difficile infection is a common cause of nosocomial infectious diarrhea. Either in western countries or in Taiwan, C. difficile infection increased in recent years. Metronidazole and vancomycin are the traditional treatment for C. difficile infection. However, the high recurrence rate remains a challenge. In May 2012, Food and Drug Administration of the United States approved fidaxomicin as a new drug to treat C. difficile infection. Fidaxomicin is macrocyclic antibiotics with narrow antibacterial spectrum. It is only effective against Gram-positive bacteria, especially C. difficile. Therefore, fidaxomicin will not influence the growth of normal gut flora. Recent clinical trials have demonstrated that fidaxomicin achieves similar clinical cure rate as vancomycin, with a lower recurrence rate than vancomycin. The side effects of fidaxomicin and vacomycin are similar. More clinical studies are warranted to support its role in treatment of C. difficile infection.

並列關鍵字

Clostridium difficile ； Fidaxomicin