High-Dose Vancomycin in the Treatment of Clostridioides difficile Infection
Bibliographic record
Abstract
Background There is significant variability in guideline recommendations regarding the dosing of vancomycin in treating Clostridioides difficile infection (CDI). The aim of this systematic review and meta-analysis was to investigate the efficacy of high-dose vancomycin compared with other current standard of care and other CDI treatment regimens. Methods We conducted a comprehensive literature search in PubMed, the Cochrane Library, Embase, and Web of Science for publications that studied the comparative effectiveness of high-dose vancomycin to other CDI treatment regimens for the period up to July 2020. Results A total of 14 studies, 6 randomized controlled trials (372 participants) and 8 observational controlled studies (952 participants), with a total of 1324 patients were included in the final analysis. There was no statistically significant effect between high-dose vancomycin and other treatment options of CDI on clinical cure/response (odd ratio [OR], 0.70; 95% confidence interval [CI], 0.34 to 1.43; I 2 = 59%), clinical relapse and recurrence (OR, 1.01; 95% CI, 0.72–1.42; I 2 = 61%), and mortality (OR, 1.03; 95% CI, 0.37–2.84; I 2 = 44%). Conclusions High-dose oral vancomycin was not superior to other treatment regimens for the outcomes of clinical response and cure, recurrence, and mortality of CDI.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".