非达霉素(Dificid)的副作用如何缓解

Fidaxomicin (Dificid) was approved by the US FDA in May 2011 for the treatment of Clostridium difficile infection (CDI). The characteristic of fidaxomicin is that it is almost not absorbed by the intestines and mainly acts in the intestinal lumen, reducing the damage to normal flora.

Side effects of fidaxomicin (Dificid)

1. Gastrointestinal reactions

Including nausea, vomiting, abdominal pain, diarrhea, constipation, etc., which are the most common side effects.

2. Effects on the blood system

Such as anemia, neutropenia, etc., although uncommon, still require vigilance.

3. Allergic reactions

Including rash, itching, angioedema, difficulty breathing, etc. If serious, seek medical attention immediately.

4. Abnormal liver function

Many patients have slight elevations of transaminase without obvious clinical symptoms.

5. Others

such as fever, fatigue, headache, etc.

The pictures come from public channels (such as the official website of the FDA, the official website of the original drug manufacturer, etc.) and are for reference only.

Methods to alleviate the side effects of fidaxomicin (Dificid)

1. Gastrointestinal reactions

Try to avoid ingesting a large amount of high-calorie, high-fat foods at one time. It is recommended to choose easy-to-digest porridge, steamed eggs, rotten noodles and other foods, and avoid the intake of spicy and greasy foods.

2. Blood system side effects

During treatment, routine blood tests should be performed regularly to detect signs of anemia or neutropenia in a timely manner. If anemia occurs, you can appropriately increase foods rich in iron and vitamins such as red meat, green leafy vegetables, and beans.

3. Avoid infection

Avoid raw and cold food, make sure the food is thoroughly cooked, wear a mask when necessary, and avoid going to crowded places.

4. Anaphylaxis

When a severe allergic reaction occurs, fidaxomicin must be stopped immediately and prompt medical treatment. The doctor will provide the patient with emergency treatment such as antihistamines, corticosteroids or epinephrine according to the actual situation.

5. Abnormal liver function

During treatment, liver function indicators, such as ALT, AST, etc., should be checked regularly. At the same time, alcohol intake should be limited and other drugs that may damage the liver should be avoided.

Special attention and care for pediatric patients

1. Common side effects

Children are more likely to have symptoms such as fever, abdominal pain, vomiting, and rash.

2. Adjustment of dose and dosage form

Accurately adjust the dose of the drug according to the actual weight. For children who weigh more than 12.5kg and can swallow normally, fidaxomicin can be given in two divided doses, 200mg (i.e. 1 tablet) each time.

Precautions for elderly patients

Older patients are more likely to have side effects of fidaxomicin due to reduced physiological functions, so special attention is required:

1. Individualized medication evaluation

The elderly are often accompanied by multiple chronic diseases and combined medications, and the drug interactions of fidaxomicin should be comprehensively evaluated.

2. Strengthen monitoring

Regularly check the patient's blood routine, liver and kidney function and other indicators, and also pay attention to observe whether they have a series of symptoms such as fatigue, dizziness, loss of appetite, etc.