Primary Prophylaxis of Clostridioides Difficile Infection With Oral Vancomycin

NCT ID: NCT07221708

Last Updated: 2026-01-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

PHASE2/PHASE3

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-03-01

Study Completion Date

2027-12-31

Brief Summary

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The purpose of this study is to evaluate the ability of oral vancomycin in preventing Clostridioides difficile infection (CDI) in patients that are simultaneously receiving antibiotics.

Participants in this study will be placed randomly into two groups. The oral vancomycin treatment group will receive oral vancomycin two times per day simultaneously with an antibiotic plus two additional days. The no oral vancomycin control group will receive the current standard of care, which is an antibiotic and no oral vancomycin. Participation in this study will last approximately 3 months.

Detailed Description

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This research study is being conducted to evaluate the feasibility of prescribing oral vancomycin in preventing CDI in patients who are receiving concomitant systemic antibiotics.

There are two groups: one group will receive oral vancomycin 125 mg twice daily for the duration of systemic antibiotic use plus two additional days; the other group will receive the current standard of care which is no oral vancomycin. The investigators aim to collect data from 100 patients in each group for a total of 200 patients.

Eligible participants will be randomized in a 1:1 ratio to receive either oral vancomycin or no oral vancomycin. A computer-generated randomization sequence has been created using block randomization with variable block sizes (4, 6, 8) to maintain group balance and reduce predictability.

Conditions

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Clostridioides Difficile Vancomycin Resistance Enterococcus Faecium

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Oral Vancomycin

The oral vancomycin treatment group will receive oral vancomycin 125 mg twice daily for the duration of the concomitant antibiotic plus two additional days.

Group Type EXPERIMENTAL

Vancomycin (POC)

Intervention Type DRUG

A dosage of oral vancomycin 125 mg will be given twice daily for the duration of the concomitant antibiotic plus two additional days

No Oral Vancomycin

The no oral vancomycin control group will receive the current standard of care treatment which is an antibiotic with no oral vancomycin.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Vancomycin (POC)

A dosage of oral vancomycin 125 mg will be given twice daily for the duration of the concomitant antibiotic plus two additional days

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Age 65 years or older
* Receive systemic antibiotics in the last 90 days
* Hospitalized anywhere in the last 90 days
* History of C diff colonization without history of C diff colitis (infection)
* Provide informed consent
* Read and understand the English language
* Not current taking probiotics
* Lack of allergy or contraindications to receive vancomycin
* Ability to take oral medications
* Not receiving medications that can be used to treat or prevent C diff

Exclusion Criteria

* Age 64 years or younger
* Has not received systemic antibiotics in the last 90 days
* Has not been hospitalized in the last 90 days
* History of C diff colonization with a history of C diff colitis (infection)
* Not provided informed consent
* Cannot read and understand the English language
* Currently receiving probiotics
* Allergy or contraindications to receive vancomycin
* Unable to take oral medications
* Receiving medications that can be used to treat or prevent C diff
Minimum Eligible Age

65 Years

Maximum Eligible Age

100 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Maryland, Baltimore Washington Medical Center

UNKNOWN

Sponsor Role collaborator

University of Maryland, Baltimore

OTHER

Sponsor Role lead

Responsible Party

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Jeffrey Marshall

Associate Chief Medical Officer and VP of Quality and Patient Safety

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jeffrey Marshall, MD

Role: PRINCIPAL_INVESTIGATOR

University of Maryland, Baltimore Washington Medical Center

Locations

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University of Maryland Baltimore Washington Medical Center

Glen Burnie, Maryland, United States

Site Status

Countries

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United States

Central Contacts

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Loren Daoud, MPH

Role: CONTACT

410-787-4474

Jennifer Emel

Role: CONTACT

410-553-8048

Facility Contacts

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Loren Daoud, MPH

Role: primary

410-787-4474

Jennifer Emel

Role: backup

410-553-8048

References

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Ganetsky A, Han JH, Hughes ME, Babushok DV, Frey NV, Gill SI, Hexner EO, Loren AW, Luger SM, Mangan JK, Martin ME, Smith J, Freyer CW, Gilmar C, Schuster M, Stadtmauer EA, Porter DL. Oral Vancomycin Prophylaxis Is Highly Effective in Preventing Clostridium difficile Infection in Allogeneic Hematopoietic Cell Transplant Recipients. Clin Infect Dis. 2019 May 30;68(12):2003-2009. doi: 10.1093/cid/ciy822.

Reference Type BACKGROUND
PMID: 30256954 (View on PubMed)

Papic N, Maric LS, Vince A. Efficacy of oral vancomycin in primary prevention of Clostridium Difficile infection in elderly patients treated with systemic antibiotic therapy. Infect Dis (Lond). 2018 Jun;50(6):483-486. doi: 10.1080/23744235.2018.1425551. Epub 2018 Jan 11. No abstract available.

Reference Type BACKGROUND
PMID: 29323607 (View on PubMed)

Maraolo AE, Mazzitelli M, Zappulo E, Scotto R, Granata G, Andini R, Durante-Mangoni E, Petrosillo N, Gentile I. Oral Vancomycin Prophylaxis for Primary and Secondary Prevention of Clostridioides difficile Infection in Patients Treated with Systemic Antibiotic Therapy: A Systematic Review, Meta-Analysis and Trial Sequential Analysis. Antibiotics (Basel). 2022 Jan 30;11(2):183. doi: 10.3390/antibiotics11020183.

Reference Type BACKGROUND
PMID: 35203786 (View on PubMed)

Tariq R, Laguio-Vila M, Tahir MW, Orenstein R, Pardi DS, Khanna S. Efficacy of oral vancomycin prophylaxis for prevention of Clostridioides difficile infection: a systematic review and meta-analysis. Therap Adv Gastroenterol. 2021 Feb 23;14:1756284821994046. doi: 10.1177/1756284821994046. eCollection 2021.

Reference Type BACKGROUND
PMID: 33747124 (View on PubMed)

Johnson SW, Brown SV, Priest DH. Effectiveness of Oral Vancomycin for Prevention of Healthcare Facility-Onset Clostridioides difficile Infection in Targeted Patients During Systemic Antibiotic Exposure. Clin Infect Dis. 2020 Aug 22;71(5):1133-1139. doi: 10.1093/cid/ciz966.

Reference Type BACKGROUND
PMID: 31560051 (View on PubMed)

Other Identifiers

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HP-00113868

Identifier Type: -

Identifier Source: org_study_id

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