Efficacy and Safety of RBX2660 in PUNCH CD3, a Phase III, Randomized, Double-Blind, Placebo-Controlled Trial with a Bayesian Primary Analysis for the Prevention of Recurrent Clostridioides difficile Infection
Open accessAbstract
Recurrent Clostridioides difficile infection, associated with dysbiosis of gut microbiota, has substantial disease burden in the USA. RBX2660 is a live biotherapeutic product consisting of a broad consortium of microbes prepared from human stool that is under investigation for the reduction of recurrent C. difficile infection. A randomized, double-blind, placebo-controlled, phase III study, with a Bayesian primary analysis integrating data from a previous phase IIb study, was conducted. Adults who had one or more C. difficile infection recurrences with a positive stool assay for C. difficile and who were previously treated with standard-of-care antibiotics were randomly assigned 2:1 to receive a subsequent blinded, single-dose enema of RBX2660 or placebo. The primary endpoint was treatment success, defined as the absence of C. difficile infection diarrhea within 8 weeks of study treatment. Of the 320 patients screened, 289 were randomly assigned and 267 received blinded treatment (n = 180, RBX2660; n = 87, placebo). Original model estimates of treatment success were 70.4% versus 58.1% with RBX2660 and placebo, respectively. However, after aligning the data to improve the exchangeability and interpretability of the Bayesian analysis, the model-estimated treatment success rate was 70.6% with RBX2660 versus 57.5% with placebo, with an estimated treatment effect of 13.1% and a posterior probability of superiority of 0.991. More than 90% of the participants who achieved treatment success at 8 weeks had sustained response through 6 months in both the RBX2660 and the placebo groups. Overall, RBX2660 was well tolerated, with manageable adverse events. The incidence of treatment-emergent adverse events was higher in RBX2660 recipients compared with placebo and was mostly driven by a higher incidence of mild gastrointestinal events. RBX2660 is a safe and effective treatment to reduce recurrent C. difficile infection following standard-of-care antibiotics with a sustained response through 6 months. NCT03244644; 9 August, 2017. Clostridioides difficile is a diarrhea-causing bacterium that is associated with potentially serious and fatal consequences. Antibiotics used to treat or prevent infections have a side effect of damaging the healthy protective gut bacteria (microbiota). Damage to the gut microbiota can allow C. difficile to over-grow and produce toxins that injure the colon. Paradoxically, the standard of care treatment of C. difficile infection (CDI) is antibiotics. Although initially effective for the control of diarrhea, antibiotics can leave a patient at risk for CDI recurrence after antibiotic treatment is stopped. Live biotherapeutic products are microbiota-based treatments used to repair the gut microbiota. These products have been shown to reduce the recurrence of CDI. RBX2660 is an investigational microbiota-based live biotherapeutic. RBX2660 contains a diverse set of microorganisms. RBX2660 has been developed to reduce CDI recurrence in adults following antibiotic treatment for recurrent CDI. This study was conducted to demonstrate that RBX2660 is effective and safe in treating patients with recurrent CDI. Treatment was considered successful in participants who did not experience CDI recurrence within 8 weeks after administration. Overall, statistical modeling demonstrated that 70.6% of participants treated with RBX2660 and 57.5% of participants treated with placebo remained free of CDI recurrence through 8 weeks. A 13.1 percentage point increase in treatment success was observed with RBX2660 treatment compared with placebo. In participants who achieved treatment success at 8 weeks, more than 90% remained free of CDI recurrence through 6 months. The most common side effects with RBX2660 treatment were abdominal pain and diarrhea. No serious treatment-related side effects were reported. The current data from the comprehensive clinical development program support a positive benefit-risk profile for RBX2660 in the reduction of CDI recurrence in adults following antibiotic therapy for recurrent CDI.
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FMT has achieved a significant milestone following FDA approval of RBX2660 (Rebyota) and SER-109 (Vowst) for prevention of recurrent Clostridioides difficile infection, highlighting therapeutic potential of FMT in human disease.
“Notably, FMT has achieved a significant milestone following the recent FDA approval of RBX2660 (Rebyota) and SER-109 (Vowst) for the prevention of recurrent Clostridioides difficile infection, highlighting the therapeutic potential of FMT in human disease.729–731”
From Microbiota–gut–brain axis and its therapeutic applications in neurodegenerative diseases (2024) · cites this paper as [730]
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MethodSelf-citationTurjeman, S. C., Rozera, T., Elinav, E., Ianiro, G., & Koren, O. (2025) · Cell · doi:10.1016/j.cell.2025.01.038 · Cited by 53 · see citing works
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“50,52 This is similar to the success rates reported for FMT which range from 81% to 93%.”
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BackgroundFecal microbiota transplantation: present and future
Cha, R. R., & Sonu, I. S. (2025) · Clinical Endoscopy · doi:10.5946/ce.2024.270 · Cited by 31 · see citing works
“19,20 REBYOTA is a live biotherapeutic product composed of a broad consortium of microorganisms derived from human stool and delivered via enema.”
Integrative systems biology approaches for analyzing microbiome dysbiosis and species interactions
Rehman, S. S. U., Nasar, M. I., Mesquita, C. S., Khodor, S. A., Notebaart, R. A., Ott, S., Mundra, S., Arasardanam, R. P., Muhammad, K., & Alam, M. T. (2025) · Briefings in Bioinformatics · doi:10.1093/bib/bbaf323 · Cited by 33 · see citing works
“…efforts include standardizing donor screening, developing defined microbial consortia, implementing metagenomic testing [129–131], and advancing Food and Drug Administration (FDA)-approved therapies such as RBX2660 (Rebyota) and SER-109 (Vowst) for recurrent C. difficile infection [132, 133].”
Wang, Y., Hunt, A., Danziger, L. H., & Drwiega, E. N. (2024) · Antibiotics · doi:10.3390/antibiotics13050436 · Cited by 29 · see citing works
“AEs were reported in 55.6% of the treatment arm and 44.8% of patients in the placebo arm [87].”
BackgroundMethodInfluentialMicrobiome-based therapeutics for Parkinson's disease
Hamilton, A. M., Krout, I. N., White, A. C., & Sampson, T. R. (2024) · Neurotherapeutics · doi:10.1016/j.neurot.2024.e00462 · Cited by 31 · see citing works
A review of engraftment assessments following fecal microbiota transplant
Herman, C., Barker, B. M., Bartelli, T. F., Chandra, V., Krajmalnik‐Brown, R., Jewell, M., Li, L., Liao, C., McAllister, F. M., Nirmalkar, K., et al. (2025) · Gut Microbes · doi:10.1080/19490976.2025.2525478 · Cited by 33 · see citing works
DuPont, H. L., Dupont, A. W., & Tillotson, G. (2024) · Therapeutic Advances in Gastroenterology · doi:10.1177/17562848241253089 · Cited by 28 · see citing works
Bednárik, D. S., Földvári-Nagy, K. C., Simon, V., Rancz, A., Gede, N., Veres, D. S., Paraskevopoulos, P., Schnabel, T., Erőss, B. M., Hegyi, P., et al. (2025) · The Lancet Regional Health - Europe · doi:10.1016/j.lanepe.2024.101151 · Cited by 30 · see citing works
Bainum, T. B., Reveles, K. R., Hall, R. G., Cornell, K., & Álvarez, C. A. (2023) · Microorganisms · doi:10.3390/microorganisms11020387 · Cited by 29 · see citing works
“RBX2660 is another microbiota-based live biotherapeutic containing several microorganisms prepared from screened donor stool [84].”
BackgroundAlshrari, A. S., Hudu, S. A., El-Migdadi, F., & Imran, M. (2023) · Biomedicines · doi:10.3390/biomedicines11020426 · Cited by 26 · see citing works
“Since IM-01 is derived from chicken eggs, which form part of the human diet, it is considered safe by the US FDA [104].”
BackgroundInfluentialGarey, K. W., Dubberke, E. R., Guo, A. X., Harvey, A., Yang, M., García-Horton, V., Fillbrunn, M. K., Wang, H., Tillotson, G., Bancke, L. L., et al. (2023) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofad383 · Cited by 25 · see citing works
Self-citationMonday, L., Tillotson, G., & Chopra, T. (2024) · Infection and Drug Resistance · doi:10.2147/idr.s419243 · Cited by 24 · see citing works
“11,14 Similar to the REYBOTA trials, patients who were immunocompromised or had IBD were excluded from the VOWST trials.”
BackgroundMethodZhang, F., Wang, W., Nie, Y., Li, J., & He, X. (2023) · Microbial Biotechnology · doi:10.1111/1751-7915.14317 · Cited by 24 · see citing works
Berry, P., & Khanna, S. (2023) · BioDrugs · doi:10.1007/s40259-023-00617-2 · Cited by 23 · see citing works
Self-citationWang, L., Jiang, W., Yang, M., Danzeng, Q., Liu, S., & Cui, M. (2025) · Cell Communication and Signaling · doi:10.1186/s12964-025-02275-z · Cited by 26 · see citing works
“In 2022 and 2023, two FMT products, RBX2660 and SER-109, were approved by the FDA respectively [182, 183], validating the clinical value of microbiota-based therapies.”
Antibiotic Use and the Risk of Hospital-Onset Clostridioides Difficile Infection
Gilboa, M., Regev‐Yochay, G., Meltzer, E., Cohen, I., Peretz, Y., Zilberman‐Daniels, T., Segev, A., Amit, S., Yahav, D., & Barda, N. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.25252 · Cited by 23 · see citing works
Wu, X., Ai, R., Xu, J., Wen, Q., Pan, H. Q., Zhang, Z. H., Wang, N., Fang, Y., Ding, D. F., Wang, Q., et al. (2023) · Journal of Digestive Diseases · doi:10.1111/1751-2980.13227 · Cited by 23 · see citing works
“2,6,7,35 Our previous study also found that the rate of AEs in patients with IBD significantly decreased from 26.0% (26/100) with manual FMT to 5.6% (100/1784) with WMT. 12 WMT significantly improves the safety of microbiota transplantation by reducing the levels of proinflammatory molecules…”
BackgroundMethodInfluentialFecal microbiota transplantation: Current evidence and future directions
Cymbal, M., Chatterjee, A., & Baggott, B. B. (2025) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.92a.24107 · Cited by 23 · see citing works
Clostridioides difficile pathogenesis and control
Chilton, C. H., Viprey, V. F., Normington, C., Moura, I. B., Buckley, A. M., Freeman, J., Davies, K., & Wilcox, M. H. (2025) · Nature Reviews Microbiology · doi:10.1038/s41579-025-01242-2 · Cited by 26 · see citing works
“A Bayesian model was used to demonstrate a clinically meaningful treatment effect by RBX2660 across a randomized, double-blind, placebo-controlled, Phase III study, 2017-01 and from a Phase IIb study, 2014-01 233,234 .”
Lodise, T. P., Guo, A. X., Yang, M., Cook, E. E., Song, W., Yang, D., Wang, Q., Zhao, A., & Bochan, M. R. (2023) · Advances in Therapy · doi:10.1007/s12325-023-02505-1 · Cited by 21 · see citing works
“REBYOTA (fecal microbiota, live-jslm [FMBL]) is a rectally administered suspension and is the first microbiota-based live biotherapeutic for the prevention of rCDI following antibiotic treatment for rCDI approved by the US Food and Drug Administration (FDA) [6].”
BackgroundMethodInfluentialFecal Microbiota Transplantation: Indications, Methods, and Challenges
Lee, J. Y., Kim, Y., Kim, J., & Kim, J. K. (2024) · The Journal of Microbiology · doi:10.1007/s12275-024-00184-3 · Cited by 23 · see citing works
Causal role of the gut microbiome in certain human diseases: a narrative review
Prosty, C. J., Katergi, K., Papenburg, J., Lawandi, A., Lee, T. C., Shi, H., Burnham, P., Swem, L. R., Routy, B., Yansouni, C. P., et al. (2024) · eGastroenterology · doi:10.1136/egastro-2024-100086 · Cited by 22 · see citing works
“40 However, the benefits of these agents may be overestimated because not all patients received fidaxomicin for the index episode of CDI, nor did they receive a pulse and taper regimen.”
Feuerstadt, P., Harvey, A., Yoho, D. S., Garcia‐Diaz, J., Knapple, W., & Bancke, L. L. (2023) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofad171 · Cited by 20 · see citing works
“5% for RBL and placebo, respectively [21].”
Self-citationPractical Use of RBX2660 for the Prevention of Recurrent Clostridioides difficile Infection
Feuerstadt, P., Allegretti, J. R., & Khanna, S. (2023) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000002195 · Cited by 19 · see citing works
“Mostof the adverse eventsweremildto-moderate with gastrointestinal disorders being seen most frequently (16).”
BackgroundSelf-citationTherapeutic Approach Targeting Gut Microbiome in Gastrointestinal Infectious Diseases
Han, Z., Min, Y., Pang, K., & Wu, D. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms242115654 · Cited by 19 · see citing works
Yang, J., Meng, L., Li, Y., & Huang, H. (2023) · Food & Function · doi:10.1039/d3fo02110f · Cited by 18 · see citing works
Clostridioides difficile infections; new treatments and future perspectives
Normington, C., Chilton, C. H., & Buckley, A. M. (2023) · Current Opinion in Gastroenterology · doi:10.1097/mog.0000000000000989 · Cited by 22 · see citing works
The gastrointestinal tract and Parkinson’s disease
Higinbotham, A. S., & Kilbane, C. (2024) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2023.1158986 · Cited by 20 · see citing works
Bassères, E., Eubank, T. A., Begum, K., Alam, M. J., Jo, J.-U., Le, T. M., Lancaster, C., Gonzales-Luna, A., & Garey, K. (2024) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.01621-23 · Cited by 18 · see citing works
Blount, K., Papazyan, R., Ferdyan, N., Srinivasan, K., Gonzalez, C., Shannon, W. D., & Fuchs, B. C. (2024) · The Journal of Infectious Diseases · doi:10.1093/infdis/jiae418 · Cited by 17 · see citing works
“Full inclusion and exclusion criteria have been published [12].”
InfluentialAssessing the safety of microbiome perturbations
Métris, A., Walker, A. W., Showering, A., Doolan, A., McBain, A. J., Ampatzoglou, A., Murphy, B., O’Neill, C. A., Shortt, C., Darby, E. M., et al. (2025) · Microbial Genomics · doi:10.1099/mgen.0.001405 · Cited by 18 · see citing works
Therapeutic role of gut microbiota in lung injury-related cognitive impairment
Cheng, Y., Hu, G., Deng, L., Zan, Y., & Chen, X. (2025) · Frontiers in Nutrition · doi:10.3389/fnut.2024.1521214 · Cited by 17 · see citing works
Allegretti, J. R., Feuerstadt, P., Knapple, W., Orenstein, R., Pinton, P., Sheh, A., & Khanna, S. (2025) · Inflammatory Bowel Diseases · doi:10.1093/ibd/izae291 · Cited by 16 · see citing works
“16,17 Fecal microbiota, live-jslm (RBL; REBYOTA ® , previously known as RBX2660), is the first single-dose, broad consortia, microbiota-based live biotherapeutic product approved by the US Food and Drug Administration (FDA) to prevent rCDI in adults following standard-of-care (SOC) antibiotic…”
InfluentialSelf-citationKennedy, M. S., & Chang, E. B. (2025) · Journal of Clinical Investigation · doi:10.1172/jci193969 · Cited by 16 · see citing works
“Only two live biotherapeutic products are currently approved in the US, both for the treatment of rCDI (146, 147) and each derived from a human fecal community.”
Tariq, R., Pardi, D. S., & Khanna, S. (2023) · Therapeutic Advances in Gastroenterology · doi:10.1177/17562848231174293 · Cited by 16 · see citing works
Self-citationNext-generation probiotics: an outlook into current applications and future developments
Kern, L., Tofield, A., Frame, J., & Elinav, E. (2026) · Nature Reviews Microbiology · doi:10.1038/s41579-026-01311-0 · Cited by 20 · see citing works
“This category includes REBYOTA (faecal microbiota, live-jslm) 19 and VOWST (faecal microbiota spores, live-brpk) 20 , the latter being a defined microbial consortium developed by Seres Therapeutics to prevent the recurrence of Clostridium difficile infection 21,22 .”
Advancements in Novel Live Biotherapeutic Products for Clostridioides difficile Infection Prevention
Lavoie, T., Appaneal, H. J., & LaPlante, K. L. (2023) · Clinical Infectious Diseases · doi:10.1093/cid/ciad639 · Cited by 15 · see citing works
Protection against Clostridioides difficile disease by a naturally avirulent strain
Dong, Q., Harper, S., McSpadden, E., Son, S. S., Allen, M.-M., Lin, H., Smith, R. C., Metcalfe, C. K., Burgo, V., Woodson, C., et al. (2024) · Cell Host & Microbe · doi:10.1016/j.chom.2024.11.003 · Cited by 15 · see citing works
Chitapanarux, T., Wiracha, U., Winichakoon, P., Salee, P., & Traisathit, P. (2025) · Scientific Reports · doi:10.1038/s41598-025-04986-2 · Cited by 14 · see citing works
“Emerging microbiota restoration therapies such as RBX2660 and SER-109 have also shown promising results in decreasing CDI recurrence rates 10,11 .”
Mikulska, M., Robin, C., Neofytos, D., Oltolini, C., Piekarska, A., Reigadas, E., Gil, L., Chemaly, R. F., Groll, A. H., Muñóz, P., et al. (2025) · EClinicalMedicine · doi:10.1016/j.eclinm.2025.103371 · Cited by 14 · see citing works
“127,128 Thus, the role LBP in HM/ HCT setting remains to be determined.”
Fecal microbiota transplantation-current perspective on human health
Cao, Z., Gao, T., Bajinka, O., Zhang, Y., & Yuan, X. (2025) · Frontiers in Medicine · doi:10.3389/fmed.2025.1523870 · Cited by 14 · see citing works
Nagarakanti, S., & Orenstein, R. (2023) · Infection and Drug Resistance · doi:10.2147/idr.s400570 · Cited by 14 · see citing works
“It is given as an oral capsule formulation within 2–4 days of antibiotic treatment for rCDI.”
ResultInfluentialZhou, P., Zhang, W., Liao, Y., Zhai, Z., Lu, S., Jiang, S., Hu, W., & Gong, W. (2025) · International Journal of Surgery · doi:10.1097/js9.0000000000002573 · Cited by 15 · see citing works
The Microbiome in Advanced Melanoma: Where Are We Now?
Fortman, D. D., Hurd, D. E., & Davar, D. (2023) · Current Oncology Reports · doi:10.1007/s11912-023-01431-3 · Cited by 14 · see citing works
Clostridioides difficile Infection: Landscape and Microbiome Therapeutics.
Gawey, B. J., & Khanna, S. (2023) · PubMed Central · Cited by 13 · see citing works
Self-citationpH-dependent pressure-sensitive colonic capsules for the delivery of aqueous bacterial suspensions
Abdi, F., Buzhor, M. G., Zellweger, N., Zhi-Luo, & Leroux, J. (2023) · Journal of Controlled Release · doi:10.1016/j.jconrel.2023.11.048 · Cited by 13 · see citing works
The Gut Microbiome: A Primer for the Clinician
Aroniadis, O. C., & Grinspan, A. M. (2023) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000002583 · Cited by 15 · see citing works
Stallhofer, J., Steube, A., Katzer, K., & Stallmach, A. (2024) · Visceral Medicine · doi:10.1159/000535851 · Cited by 13 · see citing works
Diagnosis and Management of Clostridioides difficile in Inflammatory Bowel Disease
Vaughn, B. P., Khoruts, A., & Fischer, M. (2024) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000003076 · Cited by 13 · see citing works
Clostridioides difficile infection: microbe-microbe interactions and live biotherapeutics
Wang, R. (2023) · Frontiers in Microbiology · doi:10.3389/fmicb.2023.1182612 · Cited by 14 · see citing works
“6% of patients treated with REBYOTA remain free of CDI recurrence within 8 weeks (Khanna et al., 2022); it requires storage at −80°C and is delivered to patients via enema.”
MethodDrug and gut microbe relationships: Moving beyond antibiotics
Kumbhare, S. V., Pedroso, I., Ugalde, J. A., Márquez‐Miranda, V., Sinha, R., & Almonacid, D. E. (2023) · Drug Discovery Today · doi:10.1016/j.drudis.2023.103797 · Cited by 12 · see citing works
Feuerstadt, P., Allegretti, J. R., Dubberke, E. R., Guo, A. X., Harvey, A., Yang, M., García-Horton, V., Fillbrunn, M. K., Tillotson, G., Bancke, L. L., et al. (2024) · Infectious Diseases and Therapy · doi:10.1007/s40121-023-00907-w · Cited by 12 · see citing works
Self-citationLive Biotherapeutic Products for the Prevention of Recurrent Clostridioides difficile Infection
Pettit, N. N., Shaeer, K. M., & Chahine, E. B. (2024) · Annals of Pharmacotherapy · doi:10.1177/10600280241239685 · Cited by 12 · see citing works
“…comparison of the 2 LBPs head-to-head, based on the efficacy outcomes from the individual trials, VOS may have an efficacy advantage over RBL. 10,11 Certain patient populations were largely excluded from phase 3 clinical trials, which warrants further investigation to better assess the…”
InfluentialLee, M. A., Questa, M., Wanakumjorn, P., Kol, A., McLaughlin, B. E., Weimer, B. C., Buono, A., Suchodolski, J. S., & Marsilio, S. (2024) · Journal of Veterinary Internal Medicine · doi:10.1111/jvim.17061 · Cited by 13 · see citing works
Can polymeric nanofibers effectively preserve and deliver live therapeutic bacteria?
Grilc, N. K., Kristl, J., & Zupančič, Š. (2024) · Colloids and Surfaces B Biointerfaces · doi:10.1016/j.colsurfb.2024.114329 · Cited by 12 · see citing works
Microbes in Health and Disease: Human Gut Microbiota
Hu, C., & Shen, H. (2024) · Applied Sciences · doi:10.3390/app142311354 · Cited by 15 · see citing works
- Authors
- Khanna, S., Assi, M., Lee, C., Yoho, D., Louie, T., Knapple, W., Aguilar, H., Garcia-Diaz, J., Wang, G. P., Berry, S. M., Marion, J., Su, X., Braun, T., Bancke, L., & Feuerstadt, P.
- Affiliations
- Mayo Clinic (US)
- University of Kansas (US)
- University of Victoria (CA)
- Kaiser Permanente (US)
- University of Calgary (CA)
- University of Florida (US)
- Berry Consultants, LLC (United States) (US)
- Yale University (US)
- Corresponding author
- Khanna, Sahil
- ORCID
- Venue
- Drugs
- Published
- 2022-10
- Volume
- 82
- Issue
- 15
- Pages
- 1527-1538
- ISSN
- 0012-6667 (ISSN-L)
- 1179-1950
- PMC
- PMC9607700
- OpenAlex
- W4307250618
- Cited by
- 301
- References
- 17
- Citations by year
- 2026: 71 · 2025: 76 · 2024: 85 · 2023: 64 · 2022: 5
- FWCI
- 28.11
- Type
- journal article
- Language
- en
- Update notices
- correction (2022-11-07)
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Drugs (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Figshare (submittedVersion, cc-by-nc)
- Figshare
- Funders
- Rebiotix Inc., a Ferring Company
- Topics
- Health Sciences › Medicine › Infectious Diseases › Clostridium difficile and Clostridium perfringens research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Keywords
- recurrent Clostridium difficile infection, RBX2660, live biotherapeutic products, recurrent infection prevention, fecal microbiota transplantation, enema, gut dysbiosis, treatment success, adverse events, antibiotic-associated diarrhea, treatment-emergent adverse events, sustained response, exchangeability, posterior probability
- MeSH terms
- Fecal Microbiota Transplantation, Adult, Anti-Bacterial Agents, Bayes Theorem, Clostridium Infections, Diarrhea, Humans, Recurrence, Clostridioides difficile, Treatment Outcome
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