Clostridium difficile infection (CDI) recurs after initial treatment in approximately one in four patients.

A new study published in Gut assessed the efficacy of rifaximin treatment in preventing CDI recurrence.

This was a multi-site, parallel group, randomized, placebo-controlled trial which enrolled patients aged 18 years and above, immediately after the resolution of CDI with metronidazole or vancomycin treatment. Participants, with the mean age of 71.9 years, were administered either rifaximin 400 mg thrice a day for 2 weeks, which was reduced to 200 mg thrice a day for 2 more weeks, or a placebo. The primary endpoint was recurrence of CDI within 12 weeks of trial entry.

The findings showed that recurrence within 12 weeks was 29.5% in the placebo group compared to 15.9% in the rifaximin group, resulting in a difference of 13.7% between the groups. The risk ratio was 0.54. Rate of adverse events were equivalent between the groups.

Hence, the results indicated that follow-on rifaximin after CDI could halve its recurrence rate.