This protocol covers the management of a first Clostridioides difficile infection recurrence — a patient who has experienced one prior CDI episode and is now presenting with a repeat infection requiring a distinct treatment strategy.
The patient has had exactly one prior CDI episode. A first recurrence calls for a targeted antibiotic approach that differs from initial treatment, as the goal is both resolving the current episode and reducing the likelihood of further recurrence.
Fidaxomicin is the preferred oral antibiotic for a first CDI recurrence. Oral vancomycin regimens — including tapered and pulsed schedules — are accepted alternatives. The choice among options depends in part on what was used to treat the original episode. Full regimen details, sequencing, and selection criteria are in the complete protocol.
Success is measured by initial clinical cure — resolution of diarrhea by the end of treatment — and by sustained response at 30 days after completing therapy.
DOI: 10.1093/cid/ciab549