A 74-year-old has a third nonfulminant C. difficile recurrence after a standard vancomycin regimen and then fidaxomicin. She is clinically stable and

Question

A 74-year-old has a third nonfulminant C. difficile recurrence after a standard vancomycin regimen and then fidaxomicin. She is clinically stable and has completed treatment for the current episode. Which strategy best reduces further recurrence?

Accepted Answer

Arrange microbiota-based therapy after a completed anti-CDI antibiotic course

Answer

Prescribe metronidazole indefinitely as suppressive therapy

Answer

Perform subtotal colectomy because any third recurrence is fulminant disease

Answer

Use oral rifampin monotherapy to eradicate asymptomatic spores

Answer

Use loperamide alone until stool frequency normalizes

Recurrent Clostridioides difficile infection — ABIM Board MCQ

A 74-year-old has a third nonfulminant C. difficile recurrence after a standard vancomycin regimen and then fidaxomicin. She is clinically stable and has completed treatment for the current episode. Which strategy best reduces further recurrence?