Objectives To assess the effectiveness of shortened regimens of vancomycin or fidaxomicin in the treatment of Clostridioides difficile infection (CDI). Methods Adult patients with CDI hospitalized from January 2022 to May 2023 were included in this observational study. In patients with CDI treated with vancomycin or fidaxomicin, antibiotic treatment was discontinued after either 5 or 7 days of vancomycin or 5 days of fidaxomicin if there was a clinical response and improvement in laboratory parameters. The control cohort was treated with the standard 10 day regimen of either vancomycin or fidaxomicin. The follow-up was 60 days. Causative C. difficile strains were characterized by ribotyping and toxin gene detection when available. Results Twenty-five patients (median age 76 years) received shortened treatment with vancomycin (n = 21), or fidaxomicin (n = 4). Five cases fulfilled the criteria for severe CDI. Twenty-three patients completed follow-up; two died from causes other than CDI, and two developed recurrent CDI (8.0%). Ribotypes (RTs) 001 and 014 were the most prevalent with 20% each. In two C. difficile isolates, binary toxin genes were detected (RTs 078 and 023). In the control group of 22 patients recurrent CDI developed in 5 patients (22.7%). No statistically significant differences were found between the groups. Conclusions Shortened treatment regimens for CDI with vancomycin and fidaxomicin were shown to be effective in our cohort of patients compared with 10 days of treatment. The recurrence rate was lower in the study group. A larger, prospective, double-blind, randomized, multicentre study is needed to support our findings.

中文翻译：

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是不是治疗艰难梭菌感染的时间越短越好？

目的 评估万古霉素或非达霉素缩短疗程治疗艰难梭菌感染 (CDI) 的有效性。方法纳入2022年1月至2023年5月住院的成年CDI患者作为观察性研究对象。在接受万古霉素或非达霉素治疗的 CDI 患者中，如果出现临床反应且实验室参数有所改善，则在万古霉素 5 或 7 天或非达霉素 5 天后停止抗生素治疗。对照组接受标准的 10 天万古霉素或非达霉素治疗方案。随访时间为60天。通过核糖分型和毒素基因检测（如果有）对致病艰难梭菌菌株进行表征。结果 25 名患者（中位年龄 76 岁）接受了万古霉素 (n = 21) 或非达霉素 (n = 4) 的缩短治疗。 5例符合严重CDI标准。 23名患者完成随访；两名患者死于 CDI 以外的原因，两名患者出现复发性 CDI (8.0%)。核糖体型 (RT) 001 和 014 最为常见，各占 20%。在两个艰难梭菌分离株中，检测到二元毒素基因（RT 078 和 023）。在 22 名患者的对照组中，5 名患者 (22.7%) 出现复发性 CDI。各组之间没有发现统计学上的显着差异。结论 与 10 天的治疗相比，万古霉素和非达霉素缩短 CDI 治疗方案在我们的患者队列中被证明是有效的。研究组的复发率较低。需要进行更大规模、前瞻性、双盲、随机、多中心研究来支持我们的研究结果。