標題: | Follow-on RifAximin for the Prevention of recurrence following standard treatment of Infection with Clostridium Difficile (RAPID): a randomised placebo controlled trial |
作者: | Major, Giles Bradshaw, Lucy Boota, Nafisa Sprange, Kirsty Diggle, Mathew Montgomery, Alan Jawhari, Aida Spiller, Robin C. Bradshaw, Lucy Boota, Nafisa Fahy, Sarah Allen, Rob Walker, Sarah Sprange, Kirsty Childs, Margo Bumphrey, Gill Simpkins, Daniel Whitaker, Keith Hodgson, Sheila Cook, Bernie Falcone, Yirga Diggle, Mathew Budd, Patrick Sloan, Tim Jalanka, Jonna Jawhari, Aida Ahmad, Saqib Foreman, Helen Garratt, Jill Pyke, Shirley Rorison, Brian Patel, Mina Shonde, Anthony Kemp, Sam Allsop, Lynn Mossad, Alison Heeley, Cheryl Taylor, Nicholas Misra, Sharat Foley, Stephen Wade, Lynn Clarke, Rebecca Kewley, Rebecca Palmer, Sally Boam, Samantha Haigh, Steve Hussain, Yassar Mossad, Alison Downes, Charlotte Grant, Claire Barnes, Elizabeth Williams, Jessica Horne, Kerry Kimber, Lindsey Harper, Margaret Fox, Peter Humphries, Ryan Brear, Tracy Abbott, Wendy Craig, Sarah Yazdani, Farah Forrest, Helen Lacey, Julia Garsed, Klara Turner, Rebecca Hebden, John Humphreys, John Fofie, Joyce Sorrel, Julie Armitage, Kelsey Ryalls, Kim Davy, Mark Agyemang, Michael Birchall, Sarah Booth, Stephen Partridge, David Lithgow, Jim Whileman, Amanda Adams-Heath, Charlotte Elphick, David Hall, Emily Naylor, Greg Toms, Julie Dear, Keith Stevenson, Lesley Wright, Stephanie Baker, Alison Yeomans, Angela Owen, Charlotte Adams, Colene Wilfred, Doyin Button, Heather Butterworth, Jeffery Jones, John Carnahan, Mandy Painter, Sharen Dhar, Anjan Clark, Anne Shaw, Claire Deane, Jill Stevenson, Lynsey Wood, Michelle Henthorn, Rebecca Nendick, Richard Kennedy, Anthony Gamble, Penny Burnip, Rachel Nayar, Deepa Hobday, David Edwards, Michelle Oates, Pauline Beard, Roderick Settle, Chris Dungla, Eleanor Crosbie, James Holden, Jill Painter, John Richardson, Leigh Fairle, Louise Carr, Pauline Cowlam, Simon Butler, Stephan Dixon, Andrew Das, Debashish Bharkhada, Dhiren Kessell, Jeannie Tate, Jemma Novasg, Jo Fosbrook, Julie Raymode, Parizade Harris, Andrew Homer, Anthony Oglesby, Arabis Jeppesen, Catherine Maitland, Dennise Gibbins, Jackie Wilshire, Simon Noyle, Emma Moss, Gloria Ashcroft, Pauline Skotnicka, Agnieska Boyce, Andrea Wheater, Gill Thompson, Jane Wong, Jason Tregonning, Julie Ramadas, Arvind Sweeney, Danielle Dallal, Helen McGivern, Julie Jackson, Wendy Hanson, Clare Brewer, Chris Graham, Clive Hetherington, Emily Crowther, Hannah Fairlamb, Helen Thronthwaite, Sarah Wilson, Toni Poultney, Una Mcskeane, Anna Crucerson, Elena King, Barbara Merritt, Carley Palmer, Caroline Narh, Christina Williams, Claire Ashrafi, Mariam Brown, Matthew Topping, Megan Stanford, Sophia Swanson, Linda Lloyd, David Cooke, Duncan Hellstrom, Johanna Gordon, John Elliott, Julie Gamble, Karen Gwiggner, Markus Brown, Matthew Croome, Victoria Frith, Angela Booker, Cheryl Ball, Darren Levell, Emma Smith, Michelle Stroud, Mike Kean, Miranda Fenn, Monica Dharmasiri, Suranda Razanskaite, Violetia Ford, Meirion Said, Rasha Day, Tracey Jones, Graeme Mitchell, Julie Bitouche, Yazmin Hammond, Clare Sahota, Gurminder Steed, Helen Rankin, Jayne Patel, Jaynesh Kauldhar, Kelly Green, Marie Reid, Matthew Cooper, Michael Agrawal, Anurag Hill, Gavin Foot, Helen Dumville, Jane Fairweather, Mark Lancaster, Nicola Hone, Sarah Commey, Thelma Allcock, Clare Smith, Jacqueline Mohankumar, Lakshimpriya Gidda, Ranjit Ishaq, Sauid Merotra, Susan Stacey, Danielle Das, Dave Taylor, Emma Foley, Gail Curtis, Janette Orrell, Lucy Holland, Maureen Taylor, Moira Scanlon, Sarah Graham, Susan Mahmood, Zahid Dugh, Parveen Gyawali, Pranab Tsui, Salina McClusky, Theresa Wiseman, WanTei Rommel, Butwana Patel, Meera Premchand, Purushothaman Spencer, Kevin Davis, Rob Goodye, Sacha Rahman, Anisur Witele, Eric Notcheva, Gaynor Chung-Faye, Guy Flanagan, Joanna Mandar, Kirandip Choong, Lee Meng Adedeji, Oluwafunmilayo Tashi, Surabhi 交大名義發表 National Chiao Tung University |
公開日期: | 1-七月-2019 |
摘要: | Background Clostridium difficile infection (CDI) recurs after initial treatment in approximately one in four patients. A single-centre pilot study suggested that this could be reduced using ' follow-on' rifaximin treatment. We aimed to assess the efficacy of rifaximin treatment in preventing recurrence. Methods A multisite, parallel group, randomised, placebo controlled trial recruiting patients aged >= 18 years immediately after resolution of CDI through treatment with metronidazole or vancomycin. Participants received either rifaximin 400 mg three times a day for 2 weeks, reduced to 200 mg three times a day for a further 2 weeks or identical placebo. The primary endpoint was recurrence of CDI within 12 weeks of trial entry. Results Between December 2012 and March 2016, 151 participants were randomised to either rifaximin or placebo. Primary outcome data were available on 130. Mean age was 71.9 years (SD 15.3). Recurrence within 12 weeks was 29.5% (18/61) among participants allocated to placebo compared with 15.9% (11/69) among those allocated to rifaximin, a difference between groups of 13.7% (95% CI -28.1% to 0.7%, p=0.06). The risk ratio was 0.54 (95% CI 0.28 to 1.05, p=0.07). During 6-month safety follow-up, nine participants died in each group (12%). Adverse event rates were similar between groups. Conclusion While ' follow-on' rifaximin after CDI appeared to halve recurrence rate, we failed to reach our recruitment target in this group of frail elderly patients, so the estimated effect of rifaximin lacks precision. A meta-analysis |
URI: | http://dx.doi.org/10.1136/gutjnl-2018-316794 http://hdl.handle.net/11536/152332 |
ISSN: | 0017-5749 |
DOI: | 10.1136/gutjnl-2018-316794 |
期刊: | GUT |
Volume: | 68 |
Issue: | 7 |
起始頁: | 1224 |
結束頁: | 1231 |
顯示於類別: | 期刊論文
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