Oral Vancomycin Linked to Lower Clostridioides difficile Recurrence but Raises VRE Concerns: JAMA
Researchers have found in a new randomized clinical trial that oral vancomycin reduced recurrent C. difficile infection (CDI) rates in patients taking antibiotics for non-CDI indications, though the study was underpowered to reach statistical significance. A significant difference in VRE (vancomycin-resistant enterococci) carriage was noted at 8 weeks, with VRE decreasing in the placebo group but not in the vancomycin group. The findings therefore emphasize the need to explore alternative interventions for preventing CDI recurrence. The study was published in JAMA by Julie A. and colleagues.
This study was performed in four major health systems in the Upper Midwest region of the United States. Adult participants who had completed treatment for CDI in the past 180 days and were being prescribed systemic antibiotics for unrelated infections were enrolled from May 21, 2018, through March 30, 2023. A total of 81 patients were randomized in a 1:1 ratio to receive either 125 mg of oral vancomycin once daily or a placebo, administered during the course of systemic antibiotic therapy plus 5 days post-antibiotic use. Participants were followed up for 8 weeks after completion of study treatment to determine recurrence and other outcomes.
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