Table 3.

Emerging preventive strategies for CDI in IBD patients.

Strategy	Explanation	Challenges	References
Antimicrobial stewardship	Optimize antibiotic use to preserve gut microbiota and reduce CDI risk	Requires institutional support, education, diagnostic clarity and resource allocation	Baur et al. (2017)
Probiotics and prebiotics	Restore gut microbial balance and enhance colonization resistance; potential to reduce CDI incidence	Efficacy in IBD uncertain; risk of infections in immunocompromised; strain and dose variability	Goldenberg et al. (2017)
Vaccination against C. difficile	Vaccines targeting toxins to generate protective immunity; candidates under clinical trials	Immunocompromised patient response, safety concerns, long-term efficacy and timing of vaccination	Wilcox (2012)
Microbiome modulation	Use of targeted live biotherapeutics, bacteriophages, and microbiota-based drugs to restore healthy gut flora	Experimental; safety and efficacy in IBD populations need validation	Buffie et al. (2014) and Khanna et al. (2016)
Personalized risk assessment and predictive modeling	Use of genetics, clinical data, microbiome profiles and machine learning to identify high-risk patients and tailor prevention	Requires large data sets, integration into clinical workflows and ongoing validation	Singh (2019)