Continuing Medical Education Questions: March 2026

Article Title: Diagnosis and Management of Clostridioides difficile LEARNING OBJECTIVE After this activity, the participant will be able to recognize patients at high risk for recurrent Clostridioides difficile infection and will be able to develop different strategies to optimize C. difficile treatment. CASE 1 An 80-year-old woman with diabetes and chronic kidney disease presents with recurrent C. difficile infection 2 months after the initial infection. The patient appears clinically stable. Her initial infection was treated with vancomycin for 10 days. QUESTION 1 What is the best next step in the management of this patient? Fecal microbiota transplantation Oral vancomycin 125 mg 4 times daily for 10 days Fecal microbiota spores, live-brpk 4 capsules daily for 3 days Fidaxomicin 200 mg twice daily for 10 days CASE 2 A 43-year-old man with asthma and gastroesophageal reflux disease well controlled on proton pump inhibitor (PPI) is successfully treated with oral vancomycin for C. difficile infection after receiving antibiotics for dental surgery. QUESTION 2 Which factor increases the patient's risk for developing recurrent C. difficile infection? Male gender Age 40–50 years PPI use Gastroesophageal reflux disease QUESTION 3 What additional therapy should be considered in a high-risk patient with a first case of recurrent C. difficile infection treated with fidaxomicin? Oral vancomycin 125 mg 4 times daily for 10 days Fecal microbiota, live-jslm single 150 mL enema Oral metronidazole 500 mg 3 times daily for 10 days Vancomycin 500 mg enemas 4 times daily for 2–5 days