{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T17:57:09Z","timestamp":1774115829432,"version":"3.50.1"},"reference-count":28,"publisher":"Cambridge University Press (CUP)","issue":"6","license":[{"start":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T00:00:00Z","timestamp":1706572800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X24000047_as1\"><jats:title>Background:<\/jats:title><jats:p>There is a paucity of data guiding treatment duration of oral vancomycin for <jats:italic>Clostridiodes difficile<\/jats:italic> infection (CDI) in patients requiring concomitant systemic antibiotics.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24000047_as2\"><jats:title>Objectives:<\/jats:title><jats:p>To evaluate prescribing practices of vancomycin for CDI in patients that required concurrent systemic antibiotics and to determine whether a prolonged duration of vancomycin (&gt;14 days), compared to a standard duration (10\u201314 days), decreased CDI recurrence.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24000047_as3\"><jats:title>Methods:<\/jats:title><jats:p>In this retrospective cohort study, we evaluated adult hospitalized patients with an initial episode of CDI who were treated with vancomycin and who received overlapping systemic antibiotics for &gt;72 hours. Outcomes of interest included CDI recurrence and isolation of vancomycin-resistant <jats:italic>Enterococcus<\/jats:italic> (VRE).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24000047_as4\"><jats:title>Results:<\/jats:title><jats:p>Among the 218 patients included, 36% received a standard duration and 64% received a prolonged duration of treatment for a median of 13 days (11\u201314) and 20 days (16\u201326), respectively. Patients who received a prolonged duration had a longer median duration of systemic antibiotic overlap with vancomycin (11 vs 8 days; <jats:italic>P<\/jats:italic> &lt; .001) and significantly more carbapenem use and infectious disease consultation. Recurrence at 8 weeks (12% standard duration vs 8% prolonged duration; <jats:italic>P<\/jats:italic> = .367), recurrence at 6 months (15% standard duration vs 10% prolonged duration; <jats:italic>P<\/jats:italic> = .240), and VRE isolation (3% standard duration vs 9% prolonged duration; <jats:italic>P<\/jats:italic> = .083) were not significantly different between groups. Discontinuation of vancomycin prior to completion of antibiotics was an independent predictor of 8-week recurrence on multivariable logistic regression (OR, 4.8; 95% CI, 1.3\u201318.1).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24000047_as5\"><jats:title>Conclusions:<\/jats:title><jats:p>Oral vancomycin prescribing relative to the systemic antibiotic end date may affect CDI recurrence to a greater extent than total vancomycin duration alone. Further studies are needed to confirm these findings.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2024.4","type":"journal-article","created":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T10:14:43Z","timestamp":1706609683000},"page":"717-725","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Impact of oral vancomycin treatment duration on rate of <i>Clostridioides difficile<\/i> recurrence in patients requiring concurrent systemic antibiotics"],"prefix":"10.1017","volume":"45","author":[{"given":"Diana","family":"Kwiatkowski","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6673-6091","authenticated-orcid":false,"given":"Kassandra","family":"Marsh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alyson","family":"Katz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Papadopoulos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"So","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2604-3458","authenticated-orcid":false,"given":"Vincent J.","family":"Major","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip M.","family":"Sommer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2011-0453","authenticated-orcid":false,"given":"Sarah","family":"Hochman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanina","family":"Dubrovskaya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9322-1758","authenticated-orcid":false,"given":"Serena","family":"Arnouk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2024,1,30]]},"reference":[{"key":"S0899823X24000047_ref4","doi-asserted-by":"crossref","first-page":"2326","DOI":"10.1128\/AAC.02176-12","article-title":"Meta-analysis of antibiotics and the risk of community-associated Clostridium difficile infection","volume":"57","author":"Brown","year":"2013","journal-title":"Antimicrob Agents Chemother"},{"key":"S0899823X24000047_ref28","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1186\/1471-2334-10-363","article-title":"Faecal pharmacokinetics of orally administered vancomycin in patients with suspected Clostridium difficile infection","volume":"10","author":"Gonzales","year":"2010","journal-title":"BMC Infect Dis"},{"key":"S0899823X24000047_ref1","doi-asserted-by":"crossref","first-page":"1732","DOI":"10.1056\/NEJMoa1801550","article-title":"Changes in prevalence of healthcare-associated infections in US hospitals","volume":"379","author":"Magill","year":"2018","journal-title":"N Engl J Med"},{"key":"S0899823X24000047_ref14","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1177\/1078155221998735","article-title":"Evaluating Clostridioides difficile infection (CDI) treatment duration in hematology\/oncology patients receiving concurrent non-CDI antibiotics","volume":"28","author":"Keats","year":"2022","journal-title":"J Oncol Pharm Pract"},{"key":"S0899823X24000047_ref9","doi-asserted-by":"crossref","first-page":"e336","DOI":"10.1016\/S1473-3099(22)00274-2","article-title":"How can patients with Clostridioides difficile infection on concomitant antibiotic treatment be best managed?","volume":"22","author":"Fitzpatrick","year":"2022","journal-title":"Lancet Infect Dis"},{"key":"S0899823X24000047_ref11","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1056\/NEJMoa0910812","article-title":"Fidaxomicin versus vancomycin for Clostridium difficile infection","volume":"364","author":"Louie","year":"2011","journal-title":"N Engl J Med"},{"key":"S0899823X24000047_ref15","doi-asserted-by":"crossref","unstructured":"15. 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