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Both oral vancomycin and oral metronidazole are effective treatments for patients with Clostridium difficile infection (CDI). Although neither drug has clearly been superior in head-to-head comparisons, some clinicians feel that vancomycin is the “stronger drug.” However, because of vancomycin's expense and the ever-present worry about drug resistance, current guidelines recommend reserving vancomycin for patients with severe disease. Does this policy make sense? Researchers reviewed a large Veterans Affairs database and identified 2068 CDI patients (median age, 70; 95% men) who were treated with oral vancomycin as first-line therapy between 2005 and 2012; these patients were matched by a range of comorbidities with 8069 CDI patients who re…