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The Curbsiders Internal Medicine Podcast

Supercharge your learning as these board-certified Internists interview the experts to bring you clinical pearls, practice changing knowledge, and a healthy dose of humor. 

Oct 1, 2018


Conquer Clostridium difficile (Clostridioides difficile) with this “spore-tacular” episode featuring infectious diseases expert, Dr. Curtis Donskey, Professor at Case Western Reserve University and clinician at the Louis Stokes VA Hospital. We discuss the updates in the 2017 IDSA C. difficile guidelines plus a bunch of random pearls. If you have ever laid awake at night wondering how many pills are needed for a fecal transplant, then this is the episode for you!  We discuss why metronidazole was dropped as the first line therapy for Clostridium difficile infection (CDI) along with other hot topics such as two-step testing, loperamide use, which antibiotics are the least likely to cause CDI, and more. Do not miss this episode!

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Written by: Carolyn Chan MD

Produced by: Matthew Watto MD

Hosts: Carolyn Chan MD, Matthew Watto MD, Paul Williams MD

Editor: Matthew Watto MD

Guest: Curtis Donskey, MD

Time Stamps

  • 00:00 Intro, disclaimer, guest bio
  • 02:19 Getting to know our guest, recommendations for reading, career advice
  • 06:40 Clinical case and CDI testing
  • 09:30 Testing for CDI: PCR and Two step testing
  • 16:30 Testing after treatment
  • 20:00 Treatment of initial CDI episodes, metronidazole pharmacokinetics
  • 24:15 Classification of CDI severity
  • 29:30 Fidaxomicin pearls: when to use, cost, and tapers
  • 34:10 Vancomycin tapers
  • 36:05 Fecal transplant pearls: freeze dried capsules, c-scopes, treating fulminant CDI
  • 44:44 Infection control: counseling homegoing patients, hand washing, and baths
  • 47:50 Social media questions: immodium and toxic megacolon, antibiotics less likely to promote CDI, probiotics, and more!
  • 59:14 Best CDI joke in the history of time
  • 60:00 Take home points
  • 62:42 Outro


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