The Curbsiders Internal Medicine Podcast

#494 C. diff, Diarrhea, the Microbiome, and New Therapies with Dr. Cynthia Sears. Live from Johns Hopkins Grand Rounds

Aug 11, 2025

53:25

Cancer Digestive Health Colorectal Cancer Infectious Disease Microbiome & Gut Health

Episode Description

Dominate C. diff! Learn to distinguish colonization from infection, select first-line therapies, and counsel patients on recurrence prevention and microbiome recovery. We’re joined by IDSA past president and expert on foodborne and intestinal infections, Dr. Cindy Sears (Johns Hopkins University) for a comprehensive update on Clostridioides difficile (C. diff, Cdiff, CDAD, CDI).

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Show Segments

00:00 Intro
03:00 Guest bio and hobby
04:25 Case of Charles Fleur Fontaine
06:00 Risk factors and epidemiology
08:00 Antibiotic hierarchy of risk
10:00 Diagnosis, testing strategies
14:00 Defining severity
17:30 Treatment options
20:00 Microbiome recovery strategies
24:00 Probiotics and postbiotics
27:00 Infection control counseling
30:00 C. diff and colon cancer
32:00 Recurrent C. diff strategies
35:00 Why some FMT and bezlotoxumab were discontinued
38:00 Microbiota replacement therapies
43:00 Prophylaxis strategies
45:00 Future therapies and ongoing research
47:00 Audience Q&A
52:00 Outro

Credits

Written and Produced by: Matthew Watto, MD, FACP
Cover Art and Infographic by:
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Sai S Achi MD,MBA,FACP
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Cynthia Sears MD

Disclosures

Dr. Sears reports no relevant financial disclosures. Dr. Williams financial relationships disclosed include a Merck grant or research support. This relationship has not ended.

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