Actively Recruiting

Phase 2
Phase 3
Age: 18Years +
All Genders
NCT06979609

Secondary Prevention of Clostridioides Difficile Using Vancomycin

Led by McGill University Health Centre/Research Institute of the McGill University Health Centre · Updated on 2025-09-19

300

Participants Needed

1

Research Sites

208 weeks

Total Duration

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AI-Summary

What this Trial Is About

Re-exposure to systemic antibiotics (i.e., antibiotics absorbed into the bloodstream) is common after a Clostridioides difficile infection (CDI) and is the strongest risk factor for a recurrent episode. Oral vancomycin to prevent a recurrence during antibiotic re-exposure may reduce this risk but the data supporting this practice are limited. The aim of this trial is: 1\) Does oral vancomycin prophylaxis prevent CDI recurrences in patients with recent CDI (within 120 days) and who are re-exposed to systemic antibiotics? The trial will compare oral vancomycin to placebo. Participants will: * Take the study drug (either vancomycin or placebo) twice daily for the duration of systemic antibiotics plus once daily for 7 days after completion of systemic antibiotics. * Attend an in-person follow-up at day 56 * Respond to weekly electronic questionnaires

CONDITIONS

Official Title

Secondary Prevention of Clostridioides Difficile Using Vancomycin

Who Can Participate

Age: 18Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Adults aged 18 years or older treated as inpatients or outpatients at participating institutions
  • Had an episode of CDI within the last 120 days confirmed by positive C. difficile tests and clinical symptoms
  • Received treatment for the CDI episode with vancomycin or fidaxomicin for at least 10 days with clinical cure achieved
  • Have received at least 3 days of oral or intravenous systemic antibiotics for a confirmed or suspected bacterial infection with at least one more day planned
Not Eligible

You will not qualify if you...

  • Treated the qualifying CDI episode with metronidazole alone or intravenous immunoglobulins
  • Planned or received fecal microbiota transplantation, bezlotoxumab, VOWST, or REBYOTA for the CDI episode
  • Unable to take medications orally or by nasogastric tube
  • Have had a total colectomy
  • Severe intolerance or allergy to oral vancomycin
  • Did not achieve clinical cure during CDI treatment
  • Ongoing or less than 1 day since finishing CDI treatment or CDI-active antibiotics
  • Antibiotic use is only for prophylaxis or expected to last longer than 4 weeks
  • Continuous systemic antibiotic use since CDI treatment without interruption
  • Currently in palliative care or expected to die within 3 months from another illness
  • Using non-systemic antibiotics or antibiotics not considered significant risk for CDI
  • Previously enrolled in this trial
  • Unable to consent without a healthcare proxy
  • Lack health insurance
  • Expected transfer to a non-participating site or palliative care
  • Unable to participate in follow-up or lack contact means in outpatient setting

AI-Screening

AI-Powered Screening

Complete this quick 3-step screening to check your eligibility

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Trial Site Locations

Total: 1 location

1

McGill University Health Centre

Montreal, Quebec, Canada, H4A3J1

Actively Recruiting

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Research Team

E

Emily G. McDonald, MD MSc

CONTACT

How is the study designed?

Study Type

INTERVENTIONAL

Masking

QUADRUPLE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

PREVENTION

Number of Arms

2

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