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Severe, sometimes life-threatening diarrheal disease caused by Clostridium difficile is becoming more common in hospitalized patients. Oral vancomycin or metronidazole is the usual treatment. After resolution of an episode, infection recurs (probably due to relapse) in 20% to 45% of treated patients. Now, in an empirical trial involving eight women (age range, 43–88 years) who had experienced four to eight such recurrences after standard therapy, researchers have tried using rifaximin (an off-label use of this drug, which is approved only for treatment of travelers’ diarrhea). Rifaximin is a rifamycin derivative that has low intestinal absorption and excellent in vitro activity against C. difficile.
Rifaximin therapy (400–800 mg daily in 2 o…