Recurrent Clostridioides Difficile Infection

A patient whose diarrhea 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. Canadian recommendations vary by jurisdiction and date. Québec's 2025 INESSS guide recommends fidaxomicin first for a first recurrence; older AMMI guidance and current provincial access criteria may differ. Choose treatment using recurrence history, severity, the current local guideline and access, rather than presenting one nationwide funding rule.