(1) To date, NO HOSPITAL have replaced Vancomycin with Dificid as a first line agent (2) Vancomycin has gone generic many years ago, there is no Vancomycin sales rep. Hospitals are using IV vancomycin powder to make an oral slurry for patients at $1/dose. Vancomycin capsules are seldom if ever used (3) Vast majority of C.Diff cases are caused by poor sanitary hygiene or long term administration of oral Antibiotics. Simply stopping oral antibiotic therapy will cease C.Diff issues. Elderly being treated for cellulitis (often related to Diabetes complications) often falls in this category (4) Only usefulness of Dificid is when patient symptoms are not improving in the first few days on Vancomycin. Believe me, patients not responding to vancomycin is rare. (5) CMS, IDSA (infectious Disease Society of America), CDC (Center for Disease Control) is not supporting Dificid as a first line agent for C.Diff.
Many people on this baord deserves an Oscar for drama. In real world practice, C.Diff is very very very manageable.
Approximately two-thirds of CDAD patients are 65 years of age or older. Historically, approximately 20% to 30% of CDAD patients who initially respond to treatment experience a clinical recurrence.
wow, "doc", evidence mounting that c-diff recurrence is really a greater threat than you thought (I think I quoted 20% recurrence rate in earlier posts)...also, in the 40-day study, the death rates - I believe - were 1.2% for Dificid, but 2.9% for vanco patients...3/100 die? one has to wonder what the additional 2/100 that got treated with vanco were wondering...but, then, it was less expensive...$1 vs. $150/dose...the "slurry"...oh.
btw (see your post re: "Simply stopping oral antibiotic therapy will cease C.Diff issues."), if stopping oral abx therapy is the solution to c-diff infection, why haven't you advised hospitals & physicians across the country of your miraculous cure to switch? you could get an award, possibly. In fact, why don't you tell the FDA to withdraw approval of Dificid based on your analysis?
not answering anyone's questions, but still posing as an "expert" on infectious disease...imo, of course.
I have asked you to counter the claims of the Fortress study indicating better performance over the first 12 days with patients (and even up to 40 days), to respond to issues regarding re-hospitalization costs that hospitals, CMS and insurance companies are so intensely focused on currently, to your statement that handwashing and other sanitation protocols are resulting in fewer infections in hospitals (are they? proof from you, as an expert? because it seems hospital-acquired infections are on the rise), to your claims that vanco is "cheap" (I think you use ONLY the actual drug costs of $1 vs. $150 in almost EVERY post) but without including overall costs of using vanco vs. Dificid when Dificid cuts recurrences (again, for your education, the recurrence rate is no less than 20%!!!), and the case for co-existent vanco-resistent infections commonly associated with elderly patients.
So, please stop repeating yourself re: the "slurpies" you guys are making out of powder, and answer some real questions regarding using a new and more effective treatment for c-diff that can help avoid recurrences and get patients better. And, for our sake again, please avoid your use of the argument for misuse/abuse by resident physicians...it's old already.
And, while you're at it, why don't you explain early adoption by many, many hospitals of OPTR's Dificid to their formularies...this should be interesting...and, we'll be waiting.