title: Rifaximin Redux: treatment of recurrent Clostridium difficile infections with rifaximin immediately post-vancomycin treatment.
abstract: We report our continued experience with rifaximin as a post-vancomycin treatment strategy in six patients with multiple recurrences of C. difficile infection (CDI). Four of the six patients (67%) had no further diarrhea episodes, but two patients failed shortly after or during the rifaximin treatment. C. difficile isolates from one of the two patients who failed treatment had an MIC of >256 microg/ml to rifampin. Serial therapy with vancomycin, followed by rifaximin remains an option for some patients with multiple CDI recurrences.
authors.affiliation: Research Service, Hines VA Hospital, Hines, IL 60141-3030, USA. sjohnson@lumc.edu
authors.forename: Stuart
authors.initials: S
authors.lastname: Johnson
authors.forename: Christopher
authors.initials: C
authors.lastname: Schriever
authors.forename: Ursula
authors.initials: U
authors.lastname: Patel
authors.forename: Toral
authors.initials: T
authors.lastname: Patel
authors.forename: David W
authors.initials: DW
authors.lastname: Hecht
authors.forename: Dale N
authors.initials: DN
authors.lastname: Gerding
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D016360:Clostridioides difficile / Q000187:drug effects*; D003015:Clostridium Infections / Q000188:drug therapy* / Q000517:prevention & control; D004359:Drug Therapy, Combination; D004761:Enterocolitis, Pseudomembranous / Q000188:drug therapy* / Q000517:prevention & control; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D012294:Rifamycins / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D000078262:Rifaximin; D055502:Secondary Prevention; D016896:Treatment Outcome; D014640:Vancomycin / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D005765:Gastrointestinal Agents; D012294:Rifamycins; D014640:Vancomycin; D000078262:Rifaximin