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

The Curbsiders Internal Medicine Podcast

Health & Fitness, Medicine, Science, Higher Education, Education

4.8 • 3.1K Ratings

🗓️ 11 August 2025

⏱️ 58 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

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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Transcript

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0:00.0	Hey, before we get to the show, I wanted to remind you to check out our Patreon at patreon.com
0:05.3	slash curbsiders.
0:06.4	If you haven't signed up yet, sign up now to get ad-free episodes, twice-monthly bonus episodes,
0:11.6	and a whole bunch of other cool stuff at patreon.com slash curbsiders.
0:18.3	All right, Paul, I got two for you today.
0:20.6	First one, just for the audience, so peek behind the curtain.
0:24.4	A kid on my soccer team gave me a calendar about puns, and it's been very fruitful, so
0:30.2	it's better than Google searching them, Paul.
0:32.4	All right, Paul, so the first one, first one's about poop.
0:35.7	The second one's poop adjacent.
0:55.3	And you can grade them if you want. Thanks. Toilet paper plays an important role in my life. All right. So another peek behind the curtain, by the way. So there was a moment when Matt wasn't packing yesterday where there was a moment of genuine panic when he could not find these small scraps of paper. They got no reaction from any of you.
0:55.8	All right.
0:56.6	What was the second one?
1:02.1	Yesterday, I met the vegetarian brother of Bruce Lee.
1:04.7	This is broccoli?
1:06.1	That is right, Paul. Broccoli.
1:06.7	Yeah.
1:07.1	All right.
1:07.8	Okay.
1:08.3	That made me laugh more.
1:09.9	But anyway.
1:27.9	The curbsiders podcast is for entertainment, education, and information purposes only. And the topics discussed should not be used solely diagnosed, treat, cure, or prevent any diseases or conditions. For the more of the views and statements expressed on this podcast are solely those of the host and should not be interpreted to reflect official policy or position of any entity. Aside from possibly, cash like more hospital and affiliate outreach programs. If indeed, there are any. In fact, there are none.
	...

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