175. The Internist's Guide to C.Difficile

This podcast episode features Dr. Alon Vaisman discussing the 2021 IDSA focused update on clinical practice guidelines for Clostridioides difficile infection (CDI) in adults. The discussion covers differentiating non-severe, severe, and fulminant CDI based on lab values and clinical signs. Fidaximicin is highlighted as the preferred treatment for initial and recurrent CDI episodes due to its lower recurrence rate, though its higher cost is acknowledged. The podcast further addresses managing fulminant CDI with high-dose vancomycin, potentially combined with IV metronidazole, and the criteria for surgical referral, including shock, ileus, and megacolon. The conversation also explores the nuances of CDI prophylaxis, the limited evidence for secondary prophylaxis, and infection control measures in both hospital and home settings.