Table 1.
Paper | Study Design | Intervention | Study Population | Follow-Up | Dose of Vancomycin | Effect of Vancomycin | Adverse Events |
---|---|---|---|---|---|---|---|
Cammarota et al3 (2015) Italy | Open-label, randomized and controlled trial with two arms. | 1) Feacal microbiota transplantation by colonoscopy. 2) vancomycin. | 20 individuals received feacal microbiota transplantation, and 19 individuals received vancomycin. Median number of recurrences in the vancomycin group: 3 |
10 weeks after end of vancomycin course. |
125mg four times a day for 10 days followed by 125–500mg every 2–3 days for at least 3 weeks. | 26% (n = 5) of individuals were cured, and 63% (n = 12) individuals had recurrence. Two individuals died from C. difficile related complications. | No adverse events specifically related to vancomycin. |
Hota et al22 (2016) Canada | Open-label, randomized and controlled trial with two arms. | 1) Feacal transplantation by enema. 2) vancomycin | 16 individuals received feacal transplantation, and 12 individuals received vancomycin. Median number of recurrences in the vancomycin group: 4.4 |
120 days. | 125mg four times a day for 14 days followed by 4 weeks of taper-and-pulse regimen: 125mg twice a day for 1 week, 125mg once a day for 1 week, 125mg every second day for 1 week, and 125mg every third day for 1 week. | 41.7% (n = 5) experienced recurrence, resolution of symptoms in 58.3% of individuals. | Early and late adverse events: Fever, nausea or vomiting, abdominal pain/vomiting, abdominal distension, abdominal bloating, feeling generally unwell, mucoid stools, bloody stools, smelly stools, fecal incontinence, anorexia, fatigue, skin rash. |
Rode et al6 (2021) Denmark | Open-label, randomized and controlled trial with three arms. | 1) rectal bacteriotherapy (12-strain mixture) by enema. 2) Faecal microbiota transplantation by enema. 3) vancomycin. |
34 individuals received faecal microbiota transplantation, 31 individuals received rectal bacteriotherapy and 31 individuals received vancomycin. 42% of participants in the vancomycin group had 2 or more recurrences. |
90 days. | 125mg four times a day for 14 days. For individuals with two or more recurrences, additional 5 weeks of taper-and pulse regimen was given: 125mg twice a day for 1 week, 125mg once a day for 1 week, 125mg every other day for 1 week, and 125mg every third day for 2 weeks. | Clinical cure rate at day 90 was 45% (n = 14). n = 3 individuals experienced treatment failure during tapering of vancomycin. |
None related to vancomycin. |
Hvas et al2 (2019) Denmark | Open-label single-center, randomized clinical trial with three arms. | 1) Faecal microbiota transplantation applied by colonoscopy or nasojejunal tube after 4–10 days of vancomycin. 2) Fidaxomycin. 3) vancomycin. | 24 individuals received faecal microbiota transplantation, 24 individuals received fidaxomicin, and 16 individuals received vancomycin. Median number of recurrences in the vancomycin group: 3 |
8 weeks. | 125mg four times a day for 10 days. | Clinical resolution and negative C. difficile test in 19% (n = 3) of individuals. | No adverse events related to a specific antibiotic treatment. |
Van Nood et al23 (2013) Holland | Open-label, randomized and controlled trial with three arms. | 1) vancomycin, bowel lavage and subsequent infusion of donor faeces through a nasoduodenal tube. 2) Vancomycin 3) Vancomycin with bowel lavage. |
16 individuals received vancomycin, bowel lavage and donor faeces, 13 individuals received vancomycin and 13 individuals received vancomycin with bowel lavage. Median number of recurrences in the vancomycin group: 3 |
10 weeks After initiation of therapy |
500mg four times a day for 14 days. | Resolution of infection in 31% of individuals (n = 4). 62% (n = 8) had recurrence after 5 weeks |
None related to vancomycin. |
Surawicz et al1 (2000) USA | Part of a double-blind, randomized and placebo-controlled trials. | 1) High dose vancomycin in combination with Saccharomyces boulardii (1g/day for 28 days). 2) High dose vancomycin in combination with placebo. |
18 individuals received vancomycin and Saccharomyces boularii and 14 individuals received vancomycin and placebo Median number of recurrences in the vancomycin group: 2.4 |
8 weeks | 2g/day for 10 days | 50% (n = 7) had recurrence of CDI. 3 individuals had 1 recurrence and 4 individuals had 2 recurrences. |
No significant difference between the two groups. Not further specified. |