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WithdrawnNCT07221708Updated Jul 29, 2026

Primary Prophylaxis of Clostridioides Difficile Infection With Oral Vancomycin

A Phase 2/3 interventional study of Vancomycin (POC) in Clostridioides Difficile and Vancomycin Resistance Enterococcus Faecium, sponsored by University of Maryland, Baltimore. Withdrawn at 1 site in United States. Open to participants aged 65 Years to 100 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-07-29.

Sponsored by University of Maryland, Baltimore · Phase 2/3, Interventional, and Prevention

Why this study was withdrawn
Recruitment for end-points deemed not feasible.
Phase
Phase 2/3
Study type
Interventional
Enrollment
0
Allocation
Randomized
Ages
65 Years to 100 Years
Sex
All
01

Study summary

The purpose of this study is to evaluate the ability of oral vancomycin in preventing Clostridioides difficile infection (CDI) in patients that are simultaneously receiving antibiotics.

Participants in this study will be placed randomly into two groups. The oral vancomycin treatment group will receive oral vancomycin two times per day simultaneously with an antibiotic plus two additional days. The no oral vancomycin control group will receive the current standard of care, which is an antibiotic and no oral vancomycin. Participation in this study will last approximately 3 months.

Read the detailed description

This research study is being conducted to evaluate the feasibility of prescribing oral vancomycin in preventing CDI in patients who are receiving concomitant systemic antibiotics.

There are two groups: one group will receive oral vancomycin 125 mg twice daily for the duration of systemic antibiotic use plus two additional days; the other group will receive the current standard of care which is no oral vancomycin. The investigators aim to collect data from 100 patients in each group for a total of 200 patients.

Eligible participants will be randomized in a 1:1 ratio to receive either oral vancomycin or no oral vancomycin. A computer-generated randomization sequence has been created using block randomization with variable block sizes (4, 6, 8) to maintain group balance and reduce predictability.

02

Conditions studied

  • Clostridioides Difficile
  • Vancomycin Resistance Enterococcus Faecium

Keywords

  • Clostridioides Difficile
  • Vancomycin Resistance Enterococcus faecium
  • C Diff
  • VRE
  • Vancomycin
  • C Diff Infection
03

In context

Clostridium Infections

310 studies on the registry are indexed under Clostridium Infections; 50 are open to participants now.

Browse Clostridium Infections studies →

Lead sponsor

University of Maryland, Baltimore is the lead sponsor of 687 studies on the registry; 130 are open to participants now.

Of its 90 completed or terminated interventional studies of FDA-regulated products, 63 (70%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
65 Years to 100 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • Age 65 years or older
  • Receive systemic antibiotics in the last 90 days
  • Hospitalized anywhere in the last 90 days
  • History of C diff colonization without history of C diff colitis (infection)
  • Provide informed consent
  • Read and understand the English language
  • Not current taking probiotics
  • Lack of allergy or contraindications to receive vancomycin
  • Ability to take oral medications
  • Not receiving medications that can be used to treat or prevent C diff

Exclusion criteria

Exclusion Criteria:

  • Age 64 years or younger
  • Has not received systemic antibiotics in the last 90 days
  • Has not been hospitalized in the last 90 days
  • History of C diff colonization with a history of C diff colitis (infection)
  • Not provided informed consent
  • Cannot read and understand the English language
  • Currently receiving probiotics
  • Allergy or contraindications to receive vancomycin
  • Unable to take oral medications
  • Receiving medications that can be used to treat or prevent C diff
05

Study design

Phase
Phase 2 / Phase 3
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
0 participants (actual)

Study arms

  • Experimental
    Oral Vancomycin

    The oral vancomycin treatment group will receive oral vancomycin 125 mg twice daily for the duration of the concomitant antibiotic plus two additional days.

    Drug: Vancomycin (POC)

  • No intervention
    No Oral Vancomycin

    The no oral vancomycin control group will receive the current standard of care treatment which is an antibiotic with no oral vancomycin.

Interventions

  • DrugVancomycin (POC)

    A dosage of oral vancomycin 125 mg will be given twice daily for the duration of the concomitant antibiotic plus two additional days

06

What researchers measure

Primary outcomes

  1. Number of participants who develop C diff after receiving oral vancomycin plus another antibiotic at the same time versus participants who do not receive oral vancomycin

    Time frame: Hospitalization duration and through 90 days post hospitalization discharge

Secondary outcomes

  1. Number of participants who develop vancomycin resistant enterococcus

    Perirectal swabs to detect vancomycin-resistant Enterococcus (VRE) will be performed at the time of study inclusion and repeated at discharge. The investigators will use this data to evaluate acquisition of resistance following exposure to vancomycin.

    Time frame: At start of study participation (baseline) and at completion of antibiotics (up to four weeks).

07

Study locations

1 site
  • University of Maryland Baltimore Washington Medical Center
    Glen Burnie, Maryland 21061, United States
08

References and documents

Publications

  • Ganetsky A, Han JH, Hughes ME, Babushok DV, Frey NV, Gill SI, Hexner EO, Loren AW, Luger SM, Mangan JK, Martin ME, Smith J, Freyer CW, Gilmar C, Schuster M, Stadtmauer EA, Porter DL. Oral Vancomycin Prophylaxis Is Highly Effective in Preventing Clostridium difficile Infection in Allogeneic Hematopoietic Cell Transplant Recipients. Clin Infect Dis. 2019 May 30;68(12):2003-2009. doi: 10.1093/cid/ciy822. PubMed 30256954 ↗
  • Papic N, Maric LS, Vince A. Efficacy of oral vancomycin in primary prevention of Clostridium Difficile infection in elderly patients treated with systemic antibiotic therapy. Infect Dis (Lond). 2018 Jun;50(6):483-486. doi: 10.1080/23744235.2018.1425551. Epub 2018 Jan 11. No abstract available. PubMed 29323607 ↗
  • Maraolo AE, Mazzitelli M, Zappulo E, Scotto R, Granata G, Andini R, Durante-Mangoni E, Petrosillo N, Gentile I. Oral Vancomycin Prophylaxis for Primary and Secondary Prevention of Clostridioides difficile Infection in Patients Treated with Systemic Antibiotic Therapy: A Systematic Review, Meta-Analysis and Trial Sequential Analysis. Antibiotics (Basel). 2022 Jan 30;11(2):183. doi: 10.3390/antibiotics11020183. PubMed 35203786 ↗
  • Tariq R, Laguio-Vila M, Tahir MW, Orenstein R, Pardi DS, Khanna S. Efficacy of oral vancomycin prophylaxis for prevention of Clostridioides difficile infection: a systematic review and meta-analysis. Ther Adv Gastroenterol. 2021 Feb 23;14:1756284821994046. doi: 10.1177/1756284821994046. eCollection 2021. PubMed 33747124 ↗
  • Johnson SW, Brown SV, Priest DH. Effectiveness of Oral Vancomycin for Prevention of Healthcare Facility-Onset Clostridioides difficile Infection in Targeted Patients During Systemic Antibiotic Exposure. Clin Infect Dis. 2020 Aug 22;71(5):1133-1139. doi: 10.1093/cid/ciz966. PubMed 31560051 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 29, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07221708
Lead sponsor
University of Maryland, Baltimore
Collaborators
University of Maryland, Baltimore Washington Medical Center
Responsible party
Jeffrey Marshall (Associate Chief Medical Officer and VP of Quality and Patient Safety, University of Maryland, Baltimore) — Principal investigator
First posted
Oct 28, 2025
Start date
Jan 1, 2027 (estimated)
Primary completion
Dec 31, 2027 (estimated)
Completion
Dec 31, 2027 (estimated)
Last update
Jul 29, 2026

Study contacts

Jeffrey Marshall, MD
principal investigator · University of Maryland, Baltimore Washington Medical Center

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is withdrawn, as verified in Jul 2026. You cannot join it, but the record below documents what was studied.

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