A repeat MR of the head approximately 8 months before presentation demonstrated a third recurrence in the operative bed.
A second recurrence occurred in 20.3% of fidaxomicin-treated patients and in 32.3% of vancomycin-treated patients, representing a 37% relative reduction with fidaxomicin.
A second recurrence was observed in seventeen feet (18 per cent) at ages ranging from fourteen months to five years, the average being three years.
In eight of these patients (17.4%), a second recurrence was observed, while in two cases (4.3%), three repetitive surgeries had to be carried out.
Following a second recurrence, subsequent episodes occur in as many as 40%60%% of patients [ 1].
A 49-year-old woman who had a second recurrence of a tumor in the right palpebral conjunctiva underwent local resection of the lesion with adjunctive cryotherapy to the surgical site.
Interestingly, when recurrence occurred later than 30 weeks after the last surgery, prognosis was significantly better compared to recurrence within 30 weeks after surgery: a second recurrence was only observed in one out of 14 patients of the former compared to 9 out of 12 in the latter (p < 0.01, odds ratio 40).
To compare the efficacy of fidaxomicin vs vancomycin in preventing a second recurrence within 28 ± 2 days of completion of treatment for the first recurrent episode, a χ test of difference in proportions was performed and 2-sided 95% confidence intervals (CIs) were derived.
In patients with a first recurrence of CDI, fidaxomicin was similar to vancomycin in achieving a clinical response at end of therapy but superior in preventing a second recurrence within 28 days.
Our results suggest that fidaxomicin or vancomycin treatment of a first recurrence of CDI produces similar initial relief of symptoms (>90% response), but fidaxomicin is superior in preventing a second recurrence within 28 days of completion of therapy.
