2021 C. difficile Treatment Guidelines

The podcast addresses updates to Clostridium difficile (C. diff) treatment guidelines, noting significant changes since the last episode on the topic. The discussion covers the identification and characteristics of virulent strains like BI/NAP1/027, linking their emergence to increased fluoroquinolone use. Initial treatment recommendations now favor fidaxomicin over vancomycin for first-time C. diff infections due to lower recurrence rates, especially in high-risk patients, with the caveat that cost and accessibility may influence treatment decisions. Adjunctive therapies, such as bezalotoxumab, are recommended for recurrent infections, while fecal transplants are considered for patients with multiple recurrences. The speakers also emphasize infection control precautions, including hand hygiene with soap and water, and highlight the importance of discontinuing inciting antibiotics when possible.