Evaluating Vancomycin Monotherapy and Dual Therapy with Nifuroxazide for Medium–Severe Clostridioides Difficile Infection

Background: All currently used therapeutic protocols and drugs for <i>Clostridioides difficile</i> infection (CDI) treatment do not have a satisfying success and usually cost a lot. Objectives: To compare the efficacy of vancomycin monotherapy vs modified dual therapy with vancomycin + n...

Full description

Saved in:
Bibliographic Details
Main Authors: Jasna Rahimić, Ervin Alibegović, Lana Lekić, Marijana Marković Boras, Amina Džidić-Krivić, Esma Karahmet Farhat, Emina Karahmet Sher
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Antibiotics
Subjects:
Online Access:https://www.mdpi.com/2079-6382/14/4/400
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849712150477537280
author Jasna Rahimić
Ervin Alibegović
Lana Lekić
Marijana Marković Boras
Amina Džidić-Krivić
Esma Karahmet Farhat
Emina Karahmet Sher
author_facet Jasna Rahimić
Ervin Alibegović
Lana Lekić
Marijana Marković Boras
Amina Džidić-Krivić
Esma Karahmet Farhat
Emina Karahmet Sher
author_sort Jasna Rahimić
collection DOAJ
description Background: All currently used therapeutic protocols and drugs for <i>Clostridioides difficile</i> infection (CDI) treatment do not have a satisfying success and usually cost a lot. Objectives: To compare the efficacy of vancomycin monotherapy vs modified dual therapy with vancomycin + nifuroxazide as a therapeutic protocol for a medium–severe form of CDI. In addition, the effects of a modified therapeutic protocol with standard monotherapy on the number of stools and stool consistency in a medium–severe CDI will be compared. Materials and Methods: A prospective, randomized, controlled clinical trial that included 60 patients divided into two groups was conducted. One group of patients was treated with vancomycin monotherapy. The other group was treated with the modified therapeutic protocol (vancomycin + nifuroxazide). Results: The modified therapy with vancomycin + nifuroxazide demonstrated enhanced pharmacological efficacy in the management of CDI compared to the standard vancomycin monotherapy. Patients treated with dual therapy reported a significantly lower number of stools in first, second and third control; first control (4.47 ± 2.20 compared to 5.70 ± 1.91 in vancomycin group (<i>p</i> = 0.024)), second control (2.37 ± 0.85 compared to 3.13 ± 0.90 in vancomycin group (<i>p</i> = 0.001)), and third control (1.53 ± 0.51 compared to 1.80 ± 0.61 in vancomycin group (<i>p</i> = 0.035)). Also, the first and third controls noted significant improvements in stool consistency, measured as a decrease in the number of completely watery stools (<i>p</i> = 0.011 and <i>p</i> < 0.001, respectively). Conclusions: Nifuroxazide and vancomycin have demonstrated accelerated improvement in patient status and hold promise as a novel dual therapeutic regimen for managing patients diagnosed with a medium–severe form of CDI.
format Article
id doaj-art-6b759ec8e47c4bb4a4e5bbd8e31925ec
institution DOAJ
issn 2079-6382
language English
publishDate 2025-04-01
publisher MDPI AG
record_format Article
series Antibiotics
spelling doaj-art-6b759ec8e47c4bb4a4e5bbd8e31925ec2025-08-20T03:14:23ZengMDPI AGAntibiotics2079-63822025-04-0114440010.3390/antibiotics14040400Evaluating Vancomycin Monotherapy and Dual Therapy with Nifuroxazide for Medium–Severe Clostridioides Difficile InfectionJasna Rahimić0Ervin Alibegović1Lana Lekić2Marijana Marković Boras3Amina Džidić-Krivić4Esma Karahmet Farhat5Emina Karahmet Sher6Faculty of Medicine, European University Kallos, Tuzla, XVIII Hrvatske Brigade 8, 75000 Tuzla, Bosnia and HerzegovinaDepartment of Clinical Center, Tuzla University, 75000 Tuzla, Bosnia and HerzegovinaFaculty of Health Studies, University of Sarajevo, Stjepana Tomića 1, 71000 Sarajevo, Bosnia and HerzegovinaInternational Society of Engineering Science and Technology UK, Nottingham NG7 1GN, UKInternational Society of Engineering Science and Technology UK, Nottingham NG7 1GN, UKFaculty of Food Technology, Juraj Strossmayer University of Osijek, 31000 Osijek, CroatiaInternational Society of Engineering Science and Technology UK, Nottingham NG7 1GN, UKBackground: All currently used therapeutic protocols and drugs for <i>Clostridioides difficile</i> infection (CDI) treatment do not have a satisfying success and usually cost a lot. Objectives: To compare the efficacy of vancomycin monotherapy vs modified dual therapy with vancomycin + nifuroxazide as a therapeutic protocol for a medium–severe form of CDI. In addition, the effects of a modified therapeutic protocol with standard monotherapy on the number of stools and stool consistency in a medium–severe CDI will be compared. Materials and Methods: A prospective, randomized, controlled clinical trial that included 60 patients divided into two groups was conducted. One group of patients was treated with vancomycin monotherapy. The other group was treated with the modified therapeutic protocol (vancomycin + nifuroxazide). Results: The modified therapy with vancomycin + nifuroxazide demonstrated enhanced pharmacological efficacy in the management of CDI compared to the standard vancomycin monotherapy. Patients treated with dual therapy reported a significantly lower number of stools in first, second and third control; first control (4.47 ± 2.20 compared to 5.70 ± 1.91 in vancomycin group (<i>p</i> = 0.024)), second control (2.37 ± 0.85 compared to 3.13 ± 0.90 in vancomycin group (<i>p</i> = 0.001)), and third control (1.53 ± 0.51 compared to 1.80 ± 0.61 in vancomycin group (<i>p</i> = 0.035)). Also, the first and third controls noted significant improvements in stool consistency, measured as a decrease in the number of completely watery stools (<i>p</i> = 0.011 and <i>p</i> < 0.001, respectively). Conclusions: Nifuroxazide and vancomycin have demonstrated accelerated improvement in patient status and hold promise as a novel dual therapeutic regimen for managing patients diagnosed with a medium–severe form of CDI.https://www.mdpi.com/2079-6382/14/4/400<i>Clostridioides difficile</i> infection (CDI)modified therapeutic protocolvancomycinnifuroxazide and dual antibiotic therapy
spellingShingle Jasna Rahimić
Ervin Alibegović
Lana Lekić
Marijana Marković Boras
Amina Džidić-Krivić
Esma Karahmet Farhat
Emina Karahmet Sher
Evaluating Vancomycin Monotherapy and Dual Therapy with Nifuroxazide for Medium–Severe Clostridioides Difficile Infection
Antibiotics
<i>Clostridioides difficile</i> infection (CDI)
modified therapeutic protocol
vancomycin
nifuroxazide and dual antibiotic therapy
title Evaluating Vancomycin Monotherapy and Dual Therapy with Nifuroxazide for Medium–Severe Clostridioides Difficile Infection
title_full Evaluating Vancomycin Monotherapy and Dual Therapy with Nifuroxazide for Medium–Severe Clostridioides Difficile Infection
title_fullStr Evaluating Vancomycin Monotherapy and Dual Therapy with Nifuroxazide for Medium–Severe Clostridioides Difficile Infection
title_full_unstemmed Evaluating Vancomycin Monotherapy and Dual Therapy with Nifuroxazide for Medium–Severe Clostridioides Difficile Infection
title_short Evaluating Vancomycin Monotherapy and Dual Therapy with Nifuroxazide for Medium–Severe Clostridioides Difficile Infection
title_sort evaluating vancomycin monotherapy and dual therapy with nifuroxazide for medium severe clostridioides difficile infection
topic <i>Clostridioides difficile</i> infection (CDI)
modified therapeutic protocol
vancomycin
nifuroxazide and dual antibiotic therapy
url https://www.mdpi.com/2079-6382/14/4/400
work_keys_str_mv AT jasnarahimic evaluatingvancomycinmonotherapyanddualtherapywithnifuroxazideformediumsevereclostridioidesdifficileinfection
AT ervinalibegovic evaluatingvancomycinmonotherapyanddualtherapywithnifuroxazideformediumsevereclostridioidesdifficileinfection
AT lanalekic evaluatingvancomycinmonotherapyanddualtherapywithnifuroxazideformediumsevereclostridioidesdifficileinfection
AT marijanamarkovicboras evaluatingvancomycinmonotherapyanddualtherapywithnifuroxazideformediumsevereclostridioidesdifficileinfection
AT aminadzidickrivic evaluatingvancomycinmonotherapyanddualtherapywithnifuroxazideformediumsevereclostridioidesdifficileinfection
AT esmakarahmetfarhat evaluatingvancomycinmonotherapyanddualtherapywithnifuroxazideformediumsevereclostridioidesdifficileinfection
AT eminakarahmetsher evaluatingvancomycinmonotherapyanddualtherapywithnifuroxazideformediumsevereclostridioidesdifficileinfection