{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T02:22:42Z","timestamp":1789870962342,"version":"4.0.1"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T00:00:00Z","timestamp":1696464000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Merck & Co., Inc"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Recurrent Clostridioides difficile infection (rCDI) occurs frequently, and concomitant antibiotic (CA) during the initial episode for treatment of non-CDI is a major risk factor. We sought to address the comparative efficacy of fidaxomicin versus vancomycin in the setting of CA during the initial CDI episode.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a randomized, controlled, open-label trial at 2 hospitals in Ann Arbor, Michigan. We consecutively consented and enrolled hospitalized patients \u226518 years old with diarrhea, a positive test for C. difficile, and \u22651 qualifying CA. Complicated CDI, CDI treatment for &amp;gt;24 hours prior to enrollment, and planned long-term (&amp;gt;12 weeks) CA use were notable exclusions. Clinical cure was defined as resolution of diarrhea for 2 consecutive days maintained until 2 days after therapy, and rCDI as recurrent diarrhea with positive testing \u226430 days after initial treatment. Patients were randomized to fidaxomicin or vancomycin.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Baseline characteristics were similar in the 2 groups of 144 patients. Rates of clinical cure (73% vs 62.9%, P = .195) and rCDI (3.3% vs 4.0%; P &amp;gt; .99) were similar for fidaxomicin and vancomycin in the intention-to-treat and per-protocol cohorts, respectively. Only 4 patients developed rCDI.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In this study of patients with CDI receiving CA, a numerically higher proportion were cured with fidaxomicin versus vancomycin, but this result did not reach statistical significance. Overall recurrence was lower than anticipated in both arms compared with previous studies that did not extend duration of CDI treatment during CA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Trials Registration<\/jats:title>\n                  <jats:p>www.clinicaltrials.gov (NCT02692651).<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciad606","type":"journal-article","created":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T20:19:35Z","timestamp":1696450775000},"page":"277-282","source":"Crossref","is-referenced-by-count":16,"title":["An Open-Label, Randomized Trial Comparing Fidaxomicin With Oral Vancomycin for the Treatment of <i>Clostridioides difficile<\/i> Infection in Hospitalized Patients Receiving Concomitant Antibiotics for Concurrent Infections"],"prefix":"10.1093","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9213-7850","authenticated-orcid":false,"given":"Krishna","family":"Rao","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of Michigan Medical School, University of Michigan , Ann Arbor, Michigan , USA"},{"name":"Division of Infectious Diseases, University of Michigan Medical School, University of Michigan , Ann Arbor, Michigan , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianzi","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Michigan Medical School, University of Michigan , Ann Arbor, Michigan , USA"},{"name":"Division of Infectious Diseases, University of Michigan Medical School, University of Michigan , Ann Arbor, Michigan , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Michigan Medical School, University of Michigan , Ann Arbor, Michigan , USA"},{"name":"Division of Infectious Diseases, University of Michigan Medical School, University of Michigan , Ann Arbor, Michigan , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Krishnan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Michigan Medical School, University of Michigan , Ann Arbor, Michigan , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oryan","family":"Henig","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Michigan Medical School, University of Michigan , Ann Arbor, Michigan , USA"},{"name":"Division of Infectious Diseases, University of Michigan Medical School, University of Michigan , Ann Arbor, Michigan , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolene","family":"Daniel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Michigan Medical School, University of Michigan , Ann Arbor, Michigan , USA"},{"name":"Division of Infectious Diseases, University of Michigan Medical School, University of Michigan , Ann Arbor, Michigan , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kara","family":"Sawaya","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Trinity Health Michigan , Ann Arbor, Michigan , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owen","family":"Albin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Michigan Medical School, University of Michigan , Ann Arbor, Michigan , USA"},{"name":"Division of Infectious Diseases, University of Michigan Medical School, University of Michigan , Ann Arbor, Michigan , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P","family":"Mills","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Michigan Medical School, University of Michigan , Ann Arbor, Michigan , USA"},{"name":"Division of Infectious Diseases, University of Michigan Medical School, University of Michigan , Ann Arbor, Michigan , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay A","family":"Petty","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Michigan Medical School, University of Michigan , Ann Arbor, Michigan , USA"},{"name":"Division of Infectious Diseases, University of Michigan Medical School, University of Michigan , Ann Arbor, Michigan , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Gregg","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Michigan Medical School, University of Michigan , Ann Arbor, Michigan , USA"},{"name":"Division of Infectious Diseases, University of Michigan Medical School, University of Michigan , Ann Arbor, Michigan , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Kaul","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Michigan Medical School, University of Michigan , Ann Arbor, Michigan , USA"},{"name":"Division of Infectious Diseases, University of Michigan Medical School, University of Michigan , Ann Arbor, Michigan , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anurag N","family":"Malani","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Trinity Health Michigan , Ann 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