Update Highlights

Metronidazole no longer recommended for mild CDI.

First line CDI treatment recommendations are vancomycin or fidaxomicin.

Treatment duration 10 days.

Remove inciting antibiotic when possible.

First recurrence: consider vancomycin taper or fidaxomicin.

Patients with evidence of infection based on ≥ 3 unexplained, new-onset unformed stools in 24 hours should be tested.

Diagnosis can be based on nucleic acid amplification test (NAAT) alone or a multistep algorithm involving a combination of glutamate dehydrogenase (GDH), stool toxin test, and NAAT.

Only unformed stool should be tested and repeat testing is unnecessary during the same episode of diarrhea.

No recommendation due to insufficient data.

No recommendation due to insufficient data.