Does Oral Vancomycin Prevent Clostridioides difficile Infection in Recipients of Allogeneic Hematopoietic Stem-Cell Transplant?

Clostridioides difficile infection (CDI) may be a risk factor for subsequent graft-versus-host disease (GVHD) in recipients of allogeneic hematopoietic stem-cell transplantation. Now, investigators at one transplant center retrospectively report their experience with oral vancomycin for primary CDI prevention.

Beginning in 2019, all transplant recipients also received vancomycin (125 mg orally twice daily) during their admission for transplantation as well as subsequent admissions. These recipients were compared with those who had received transplants prior to the change in protocol. CDI occurred within 100 days of transplantation in 1.4% of the 71 patients who received vancomycin compared with 23.6% of the 131 who did not. Prophylactic levo…