David H. Wesorick, MD; Vineet Chopra, MD, MSc
Disclosures: Dr. Chopra reports grants from the Agency for Healthcare Research and Quality. Dr. Wesorick has disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-1400.
In this study, patients admitted with recurrent CDI that were treated with FMT had significantly lower rates of BSI than patients treated with antibiotics. FMT patients also experienced significantly shorter lengths of stay and higher rates of CDI cure and survival at 90 days. These data suggest that FMT may be a superior treatment for recurrent CDI in this patient population.
However, the observational nature of the study and the significant differences between the 2 treatment groups make it impossible to draw firm conclusions. Randomized controlled trials will be required to accurately compare the outcomes of these treatment strategies in this patient population.
Rivaroxaban failed to show noninferiority to warfarin for thromboprophylaxis in high-risk APS but was associated with a nonsignificant increased risk for arterial thrombosis.
Reasons for rivaroxaban's higher rates of thrombosis are not clear but could be related to targeting a single coagulation factor (as opposed to several with warfarin) or treatment interruption by patients due to lack of monitoring compared with warfarin.
Editorialists note that these results are consistent with a prior noninferiority study of rivaroxaban vs. warfarin in high-risk APS and suggest that warfarin remains the anticoagulant of choice for this condition.
Wesorick DH, Chopra V. Annals for Hospitalists - 19 November 2019. Ann Intern Med. 2019;171:HO1. doi: https://doi.org/10.7326/AWHO201911190
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Published: Ann Intern Med. 2019;171(10):HO1.
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