VIDEO: Managing recurrence of C. difficile infection

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Recurrent C. diff, unfortunately, is very common and becoming increasingly more common. So about 25% of patients who have an initial episode of C. diff will recur: Once you recur once, you’ll continue to recur. It becomes exponentially more likely with each subsequent recurrence, so the curve really goes up.

And so, if the patient is continued on the same treatment over and over again, it becomes very hard to ultimately clear this infection. And that’s why a lot of the guidelines will tell you: Do something different. If you used a standard course of vancomycin, use fidaxomicin or an extended vancomycin pulse or taper. You know, do something different to try to, again, prevent that subsequent recurrence.

We know that both vancomycin and fidaxomicin treat C. diff very well. Fidaxomicin actually does better when you look at prevention of recurrence. So ultimately those treated with fidaxomicin will have less recurrences down the line.

I think getting the patient on the right therapy as early as possible and then knowing when to offer some of these alternative preventative strategies that I mentioned is really important.