ArticlePloS one2013
Defining the vulnerable period for re-establishment of Clostridium difficile colonization after treatment of C. difficile infection with oral vancomycin or metronidazole.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06979609 (Secondary Prophylaxis of Recurrent Clostridioides Difficile Infections During Systemic Antibiotics With Vancomycin), which is not on this map. Cited by 54 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Secondary Prophylaxis of Recurrent Clostridioides Difficile Infections During Systemic Antibiotics With Vancomycin: A Randomized Controlled Trial
Who cites it
54 citing papers in PubMed, 2 syntheses or guidelines pooled it, 106 citations in OpenAlex.
- Comparative effectiveness of treatments for recurrentFrontiers in pharmacology · 2024Pooled it
- Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA).Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Guideline
- Microbiome and Metabolome Restoration After Administration of Fecal Microbiota, Live-jslm (REBYOTA) for Preventing Recurrent Clostridioides difficile Infection.The Journal of infectious diseases · 2025Trial
- Multi-omic profiling a defined bacterial consortium for treatment of recurrent Clostridioides difficile infection.Nature medicine · 2025Trial
- Fecal Pharmacokinetics and Gut Microbiome Effects of Oral Omadacycline Versus Vancomycin in Healthy Volunteers.The Journal of infectious diseases · 2024Trial
- Evaluation of the effectiveness and safety of oral vancomycin versus placebo in the prevention of recurrence ofBMJ open · 2023Trial
- Safety and Tolerability of SER-109 as an Investigational Microbiome Therapeutic in Adults With Recurrent Clostridioides difficile Infection: A Phase 3, Open-Label, Single-Arm Trial.JAMA network open · 2023Trial
- SER-109, an Investigational Microbiome Drug to Reduce Recurrence After Clostridioides difficile Infection: Lessons Learned From a Phase 2 Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Trial
- Trial
- Article
- Longer durations of piperacillin/tazobactam treatment cause more prolonged alteration of colonization resistance in mice.PloS one · 2026Article
- Long-Term Follow-Up After Fecal Microbiota Transplantation via Freeze-Dried Capsules for RecurrentPathogens & immunity · 2026Article
- Vancomycin-resistant enterococci utilise antibiotic-enriched nutrients for intestinal colonisation.Nature communications · 2025Article
- The impact of ibezapolstat and otherAntimicrobial agents and chemotherapy · 2025Article
- Evaluation of Primary Oral Vancomycin Prophylaxis AgainstOpen forum infectious diseases · 2024Article
- Pulsed dosing and extended daily dosing of oral vancomycin do not facilitate clearance ofAntimicrobial agents and chemotherapy · 2024Article
- Effect of Ceftaroline, Ceftazidime/Avibactam, Ceftolozane/Tazobactam, and Meropenem/Vaborbactam on Establishment of Colonization by Vancomycin-Resistant Enterococci andPathogens & immunity · 2024Article
- Host Immune Responses toTropical medicine and infectious disease · 2023Review
- A microbial consortium alters intestinalmBio · 2023Article
- Gut microbiome health and dysbiosis: A clinical primer.Pharmacotherapy · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundClostridium difficile is an anaerobic, spore-forming bacterium that is the most common cause of healthcare-associated diarrhea in developed countries. A significant proportion of patients receiving oral vancomycin or metronidazole for treatment of Clostridium difficile infection (CDI) develop recurrences. However, the period of vulnerability to re-establishment of colonization by C. difficile after therapy is not well defined. PRINCIPAL
findingsIn a prospective study of CDI patients, we demonstrated that most vancomycin-treated patients maintained inhibitory concentrations of vancomycin in stool for 4 to 5 days after therapy, whereas metronidazole was only detectable during therapy. From the time of elimination of the antibiotics to 14 to 21 days after therapy, a majority of stool suspensions supported growth of C. difficile and deep 16S rRNA sequencing demonstrated persistent marked alteration of the indigenous microbiota. By 21 to 28 days after completion of CDI treatment, a majority of stool suspensions inhibited growth of C. difficile and there was evidence of some recovery of the microbiota.
conclusionsThese data demonstrate that there is a vulnerable period for re-establishment of C. difficile colonization after CDI treatment that begins within a few days after discontinuation of treatment and extends for about 3 weeks in most patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.