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To the Editor Although we agree that the majority of the systematic review1 of best practices for the diagnosis and treatment of C difficile infection in adults was supported by evidence, we have concerns that the conclusions about fidaxomicin may not fully reflect the available clinical data.
First, Bagdasarian and colleagues stated that fidaxomicin demonstrated noninferiority to vancomycin for clinical cure. Although clinical response was similar, phase 3 trials established, and the US Food and Drug Administration accepted, that fidaxomicin was statistically superior to vancomycin for sustained clinical response (ie, cure without recurrence or death) based on an analysis of the full set of patients.2,3
Dai C, Jiang M, Sun M. Treatment for Clostridium difficile Infection in Adults. JAMA. 2015;313(19):1975-1976. doi:10.1001/jama.2015.3671