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BACKGROUND Data on the impact of combination therapy (intravenous metronidazole [IV MTZ] plus oral vancomycin [PO VAN]) on clinical outcomes in intensive care untie (ICU ) patients with severe, non-fulminant CDI, including NAP1-positive samples, is lacking. METHODS Retrospective, observational cohort of adult patients that developed CDI in the ICU diagnosed with severe, non-fulminant CDI who received PO VAN. Patients with an order for IV MTZ started within 72 hours of PO VAN and who received at least 72 hours of combined therapy composed the combination the