Oral Vancomycin to Prevent Hospital-Acquired Clostridioides difficile Disease

In an open-label, randomized study of high-risk patients, 125 mg daily of oral vancomycin resulted in no cases of C. difficile disease, compared with six among placebo recipients.

Studies have suggested that oral vancomycin prophylaxis (OVP) may be an option for prevention of healthcare facility–onset Clostridioides difficile infection (HCFO-CDI). However, which patients might benefit remains unclear. In addition, there are concerns that OVP might increase colonization with resistant organisms, such as vancomycin-resistant Enterococcus (VRE).

To test OVP prospectively, investigators at a single large tertiary-care hospital conducted a primary prophylaxis study from October 2018 to April 2019. They randomized 100 hospitalized patients who met criteria for being high risk (age ≥60 years, prior hospitalization within 30 days with receipt of systemic antibiotics, and receipt of antibiotics during the current hospitalizati…

Reviewing Author

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Oral Vancomycin to Prevent Hospital-Acquired Clostridioides difficile Disease

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Reviewing Author