What is the best treatment for recurrent C. diff?

The combination of vancomycin and fecal microbiota transplantation is superior to only fidaxomicin or vancomycin for the treatment of recurrent Clostridium difficile infection, according to a study published in Gastroenterology.

Researchers conducted a single-center, randomized trial involving adults suffering from recurrent C. diff infection and seen at a gastroenterology clinic in Denmark, from April 5, 2016 through June 10, 2018. Patients were randomly assigned to receive FMT after four to 10 days of vancomycin, 10 days of fidaxomicin alone or 10 days of vancomycin alone.

In all, 64 patients participated in the trial. Seventeen patients who received FMT after four to 10 days of vancomycin tested negative for C. diff and achieved clinical resolution in eight weeks. Eight patients were given fidaxomicin and three patients receiving vancomycin achieved clinical resolution in the same time period.

However, there was one serious adverse event that might have been related to FMT after four to 10 days of vancomycin.

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