Patients with toxin-negative Clostridioides difficile-positive diarrhea are often treated with oral vancomycin with the assumption that treatment is more beneficial than harmful. However, this hypothesis has never been formally tested, and recent studies suggest that most such patients recover quickly without treatment and can be colonized rather than infected. Fishbein et al. conducted a prospective, placebo-controlled randomized trial to systematically evaluate the effects, risks, and benefits of oral vancomycin in these patients (S. R. S. Fishbein, T. Hink, K. A. Reske, C. Cass, et al., mSphere 6:e00936-20, 2020, https://doi.org/10.1128/mSphere.00936-20). Although small, the results are intriguing and suggest the adverse antibiotic-induced effects of vancomycin outweigh the clinical benefit when colonization is more likely than disease.

中文翻译：

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揭露艰难梭菌定殖的危害

艰难梭菌毒素阴性患者积极的腹泻通常以口服万古霉素治疗为前提，认为治疗比有害更有益。但是，这一假设从未得到正式检验，最近的研究表明，大多数此类患者无需治疗即可迅速康复，并且可以定植而不是感染。Fishbein等。进行了一项前瞻性，安慰剂对照的随机试验，以系统评估口服万古霉素对这些患者的疗效，风险和益处（SRS Fishbein，T。Hink，KA Reske，C。Cass等，mSphere 6：e00936-20 ，2020年，https：//doi.org/10.1128/mSphere.00936-20）。尽管很小，但结果令人着迷，表明当定植比疾病更可能发生时，万古霉素对抗生素的不利影响超过临床获益。