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About 20% of patients with Clostridium difficile infection (CDI) experience recurrence. In an earlier study, researchers identified risk factors for such recurrence (Lancet 2001; 357:189). Now, these researchers have developed a rule to predict recurrence and have prospectively evaluated its performance in a cohort of hospitalized patients with CDI.
The clinical prediction rule involved three variables. Patients were given 1 point for age >65, 1 point for severe or fulminant underlying illness (as determined by the Horn index, which rates disease severity as 1 of 4 categories, based on clinical judgment), and 1 point for the use of additional antibiotics after discontinuation of therapy for the initial CDI episode. Patients scoring ≥2 points…