The Intern At Work: Internal Medicine 175. The Internist's Guide to C.Difficile
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Dec 11, 2022 AI Snips
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Treatment of C. difficile Recurrence
- For first recurrence, prefer fidaxomicin with a taper or pulse regimen.
- For subsequent recurrences, consider fidaxomicin, vancomycin taper, or fecal microbiota transplantation (FMT).
Counseling on PPIs and C. difficile
- Reevaluate the necessity of proton pump inhibitors (PPIs) and discontinue if no strong indication exists.
- Evidence linking PPIs to C. difficile is inconclusive, but minimizing unnecessary use is prudent.
C. difficile Prophylaxis Guidance
- Vancomycin prophylaxis may prevent primary C. difficile infection in high-risk patients receiving antibiotics.
- There is insufficient evidence to recommend prophylaxis for secondary prevention after prior infections.