Review outlines strategies to prevent C. difficile infection and recurrence

Clostridioides difficile infection remains a cause of morbidity and healthcare use, with community-associated disease and recurrent infection continuing to pose challenges. This review summarizes evidence on preventing both initial and recurrent CDI, focusing on practical strategies for gastroenterologists. It does not report new patient data or a trial sample size.

For primary prevention, the authors discuss antimicrobial stewardship, infection prevention and control, diagnostic stewardship to distinguish colonization from infection, and measures to preserve the intestinal microbiome. For patients with CDI, the review covers extended antibiotic regimens, oral vancomycin prophylaxis during subsequent systemic antibiotic exposure, and microbiome restoration, including fecal microbiota transplantation and FDA-approved microbiota-based therapies.

The review highlights older adults, immunocompromised people, transplant recipients, and patients with inflammatory bowel disease as groups at increased risk of recurrence. It also describes emerging approaches, including risk stratification, microbiome- and metabolome-based biomarkers, bile acid modulation, and strategies targeting asymptomatic colonization. As a review rather than a new comparative study, it summarizes existing evidence but the supplied text does not provide detailed efficacy estimates or recommendations for choosing among these approaches.