Comparative Pharmacology
Head-to-head clinical analysis: CHLORAMPHENICOL versus DIFICID.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CHLORAMPHENICOL versus DIFICID.
CHLORAMPHENICOL vs DIFICID
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit, preventing peptide bond formation.
Fidaxomicin is a macrocyclic antibiotic that inhibits bacterial RNA polymerase, leading to RNA synthesis inhibition and cell death. It is bactericidal against Clostridioides difficile and has minimal systemic absorption.
50-100 mg/kg/day IV divided every 6 hours (not to exceed 4 g/day); for susceptible severe infections, 12.5-25 mg/kg IV every 6 hours.
200 mg (tablet) orally twice daily for 10 days.
None Documented
None Documented
1.5-4.0 hours in adults; prolonged to 3-7 hours in neonates and up to 24 hours in severe hepatic impairment
Clinical Note
moderateChloramphenicol + Fluconazole
"The metabolism of Fluconazole can be decreased when combined with Chloramphenicol."
Clinical Note
moderateChloramphenicol + Clotrimazole
"The metabolism of Clotrimazole can be decreased when combined with Chloramphenicol."
Clinical Note
moderateChloramphenicol + Ketoconazole
"The metabolism of Ketoconazole can be decreased when combined with Chloramphenicol."
Clinical Note
moderateChloramphenicol + Ticlopidine
11.7 hours (terminal half-life in healthy subjects); supports twice-daily dosing.
~90% renal (5-10% unchanged; remainder as inactive glucuronide), ~10% biliary/fecal
Fecal (primarily as unchanged drug, ~44% of dose); renal (~1.6% unchanged, <1% as metabolites); biliary (minor).
Category D/X
Category C
Antibiotic
Antibiotic
"The metabolism of Ticlopidine can be decreased when combined with Chloramphenicol."