Overview
Introduction
A patient whose diarrhoea returns after treatment may have recurrent C.
A patient whose diarrhoea returns after treatment may have recurrent C. difficile infection, but a positive PCR alone does not establish that diagnosis. The clinical question is whether active, toxin-producing disease has returned in a symptomatic patient, and whether the illness is severe or fulminant. Treatment decisions then depend on recurrence history, drug safety, local Canadian guidance, and access to fidaxomicin. AMMI Canada places oral vancomycin first-line, while the US IDSA/SHEA guideline prefers fidaxomicin when available; this difference reflects Canadian cost and coverage constraints rather than evidence that fidaxomicin is ineffective. [1,2,7]