{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T11:01:59Z","timestamp":1777633319802,"version":"3.51.4"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T00:00:00Z","timestamp":1701993600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006954","name":"Tufts Medical Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006954","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Tupper Family Foundation"},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1TR002544"],"award-info":[{"award-number":["UL1TR002544"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Clostridioides difficile infection (CDI) is a leading cause of morbidity in immunocompromised hosts with increased risk of complications and recurrences. In this study, we examined the clinical effectiveness of fidaxomicin vs vancomycin in treating CDI in this patient population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This single-center retrospective study evaluated patients with CDI between 2011 and 2021. The primary outcome was a composite of clinical failure, relapse at 30 days, or CDI-related death. A multivariable cause-specific Cox proportional hazards model was used to test the relationship between treatment and the composite outcome, adjusting for confounders and treating death from other causes as a competing risk.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>This study analyzed 238 patients who were immunocompromised and treated for CDI with oral fidaxomicin (n = 38) or vancomycin (n = 200). There were 42 composite outcomes: 4 (10.5%) in the fidaxomicin arm and 38 (19.0%) in the vancomycin arm. After adjustment for sex, number of antecedent antibiotics, CDI severity and type of immunosuppression, fidaxomicin use significantly decreased the risk of the composite outcome as compared with vancomycin (10.5% vs 19.0%; hazard ratio, 0.28; 95% CI, .08\u2013.93). Furthermore, fidaxomicin was associated with 70% reduction in the combined risk of 30- and 90-day relapse following adjustment (hazard ratio, 0.27; 95% CI, .08\u2013.91).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The findings of this study suggest that the use of fidaxomicin for treatment of CDI reduces poor outcomes in patients who are immunocompromised.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofad622","type":"journal-article","created":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T13:21:48Z","timestamp":1702041708000},"source":"Crossref","is-referenced-by-count":11,"title":["Comparative Effectiveness of Fidaxomicin vs Vancomycin in Populations With Immunocompromising Conditions for the Treatment of <i>Clostridioides difficile<\/i> Infection: A Single-Center Study"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1239-3510","authenticated-orcid":false,"given":"Majd","family":"Alsoubani","sequence":"first","affiliation":[{"name":"Division of Geographic Medicine and Infectious Diseases, Department of Medicine, Tufts Medical Center , Boston, Massachusetts , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer K","family":"Chow","sequence":"additional","affiliation":[{"name":"Division of Geographic Medicine and Infectious Diseases, Department of Medicine, Tufts Medical Center , Boston, Massachusetts , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angie Mae","family":"Rodday","sequence":"additional","affiliation":[{"name":"Tufts Clinical and Translational Science Institute, Tufts Medical Center , Boston, Massachusetts , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Kent","sequence":"additional","affiliation":[{"name":"Predictive Analytics and Comparative Effectiveness Center, Tufts Medical Center, School of Medicine, Tufts University , Boston, Massachusetts , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David R","family":"Snydman","sequence":"additional","affiliation":[{"name":"Division of Geographic Medicine and Infectious Diseases, Department of Medicine, Tufts Medical Center , Boston, Massachusetts , USA"},{"name":"The Stuart B. Levy Center for the Integrated Management of Antimicrobial Resistance, School of Medicine, Tufts University , Boston, Massachusetts , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,12,8]]},"reference":[{"key":"2024020218174318000_ofad622-B1","doi-asserted-by":"crossref","DOI":"10.15620\/cdc:82532","volume-title":"Antibiotic resistance threats in the United States","author":"Centers for Disease Control and Prevention","year":"2019"},{"key":"2024020218174318000_ofad622-B2","doi-asserted-by":"crossref","first-page":"2144","DOI":"10.1093\/cid\/ciy845","article-title":"Clostridium difficile in immunocompromised hosts: a review of epidemiology, risk factors, treatment, and prevention","volume":"68","author":"Revolinski","year":"2019","journal-title":"Clin Infect Dis"},{"key":"2024020218174318000_ofad622-B3","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.ijid.2019.10.028","article-title":"Clostridioides 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