Podcast Ep 44: Clostridium Difficile Guidelines

The podcast addresses Clostridium Difficile infections, referencing updated 2018 guidelines and listener requests. It highlights risk factors such as antibiotic use—particularly fluoroquinolones, cephalosporins, and clindamycin—and PPIs, though the guidelines suggest continuing PPIs if medically necessary. The discussion covers diagnostic approaches, emphasizing stool samples for C. diff toxin, and treatment strategies, including vancomycin and fidoxomycin as preferred over metronidazole for initial episodes in adults. Recurrent infections are addressed with options like tapered vancomycin regimens, fecal microbiota transplantation, and the monoclonal antibody Bezlotoxumab (Zinplava). The panel also advises against using loperamide for diarrhea and stresses the importance of handwashing to prevent spore transmission.