The Curbsiders Internal Medicine Podcast #494 C. diff, Diarrhea, the Microbiome, and New Therapies with Dr. Cynthia Sears. Live from Johns Hopkins Grand Rounds
34 snips
Aug 11, 2025 In this lively discussion, Dr. Cynthia Sears, a professor at Johns Hopkins, unpacks the complexities of Clostridioides difficile (C. diff) infections and their impact on gut health. She breaks down the difference between C. diff colonization and infection, discusses treatment strategies, and highlights microbiome recovery tactics. The conversation also dives into the challenges of recurrent infections, the role of probiotics, and the potential of new therapies, including monoclonal antibodies and microbiota replacement. A must-listen for anyone interested in gut health!
AI Snips
Chapters
Transcript
Episode notes
Century Ride For Food Medicine
- Cynthia Sears rides 100 miles as 'Spinderella' for Movable Feast to combine medicine and food access.
- She has done the ride for 20 years and ties clinical work to community nutrition.
PPIs Change Microbiome And Raise C. diff Risk
- Omeprazole (PPI) alters the gut microbiome and is associated with higher C. difficile disease risk.
- Cynthia Sears highlights microbiome modification as a plausible mechanism linking PPIs to C. diff.
Prefer Lower-Risk Antibiotics
- Use lower-risk antibiotics when feasible to reduce C. difficile risk, especially in high-risk patients.
- Stop unnecessary antibiotics promptly if C. difficile is suspected to limit further microbiome disruption.