#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).

Claim CME for this episode at curbsiders.vcuhealth.org!

Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME

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.

Sponsor:
Mint Mobile 

This year, skip breaking a sweat AND breaking the bank. Get this new customer offer and your 3-month Unlimited wireless plan for just 15 bucks a month at mintmobile.com/CURB 

Sponsor:
Panacea Financial

Let Panacea Financial take the financial stress off your plate,so you can get back to doing what matters most. Visit panaceafinancial.com 

Sponsor:
FIGS

Get15% off your first order at wearfigs.com with the code FIGSRX



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
Podcast Episodes
#460 HFpEF: Heart Failure with Preserved Ejection Fraction [not-audio_url] [/not-audio_url]

Duration: 49:39
Preserve your sanity while treating heart failure with preserved ejection fraction. Dr Michelle Kittleson @MKittlesonMD (Cedars Sinai) illuminates this confounding cardiac condition.Claim CME for this episode at curbside…
#458 HFrEF: Heart Failure with Reduced Ejection Fraction [not-audio_url] [/not-audio_url]

Duration: 1:04:24
Kittleson Rules Outpatient Heart Failure Volume 1Provide superb outpatient care for your patients with HFrEF. Identify underlying causes of heart failure and titrate medications with ease. Dr Michelle Kittleson @MKittles…
#457 Cold and Flu Season: Upper Respiratory Infections aka URIs [not-audio_url] [/not-audio_url]

Duration: 1:06:25
Treating colds, flu, and more with Dr Amber Bird! Dive deep into upper respiratory viral infections with Dr Amber Bird, MD (Penn). Feel confident on when to order testing, recommend symptom relieving treatments, and avoi…
#456 Outpatient Oxygen Therapy [not-audio_url] [/not-audio_url]

Duration: 1:12:57
Supplemental oxygen is ubiquitous and yet there is a tremendous amount of uncertainty related to prescription and management in the outpatient setting. Have no fear, we’ve got your back! On this episode of The Curbsiders…
#455 Sports Injuries Part 2: Hip and Knee [not-audio_url] [/not-audio_url]

Duration: 54:04
De-stress your approach to stress fractures (and trochanteric pain syndromes and meniscus tears)!Follow along as the great Dr. Senter guides us through the diagnosis, workup, and treatment of an all-star lineup of sport…
#454 Kidney Boy on Managing Diabetes and Hypertension in CKD [not-audio_url] [/not-audio_url]

Duration: 1:05:55
Learn how to manage diabetes and hypertension in chronic kidney disease with expert tips from Kidney Boy, Kashlak’s Chief of Nephrology, Dr. Joef Topf @kidney_boy. Claim CME for this episode at curbsiders.vcuhealth.org!P…
#453 Sports Injuries Part 1: Concussion and Hip Pain [not-audio_url] [/not-audio_url]

Duration: 57:30
Follow along as the great Dr. Senter guides us through the diagnosis, workup, and treatment of an all-star lineup of sport injuries. Part 1 covers concussions, femoroacetabular impingement (FAI), and the ongoing quest to…
#451 Acute Coronary Syndrome with Dr. Sanjeev Francis - Part 2 [not-audio_url] [/not-audio_url]

Duration: 1:03:39
Quit playing games with my heartYet another beat no to skip here with part 2 of our conversation with cardiologist Dr. Sanjeev Francis (@, Maine Medical Center)for acute coronary syndrome. Learn about the warranty on str…