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

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

Author: The Curbsiders Internal Medicine Podcast August 11, 2025 Duration: 57:50
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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Tune in to The Curbsiders Internal Medicine Podcast for a direct line to practical clinical knowledge and the ever-evolving art of patient care. This isn't a dry lecture series; it's a dynamic conversation among practicing physicians who break down complex topics into actionable insights you can use. Each episode delves into the nuances of internal medicine, from managing common chronic conditions to interpreting the latest guidelines and navigating diagnostic dilemmas. You'll hear honest discussions about challenges at the bedside, evidence-based debates, and expert interviews that go beyond textbook summaries to reveal how medicine works in the real world. The podcast serves as both a continuing education resource and a professional companion, offering thoughtful analysis and clinical pearls that resonate whether you're a seasoned hospitalist, a resident in training, or a primary care provider. The focus is consistently on deepening understanding and improving daily practice, making the rounds or the clinic day feel a little less daunting and a lot more informed. Listen for a blend of curiosity, camaraderie, and a genuine commitment to mastering the craft of medicine, all delivered through engaging dialogue that feels like consulting with a trusted colleague.
Author: Language: English Episodes: 100

The Curbsiders Internal Medicine Podcast
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