Table 2.

Preventative Strategies in CDI.

	IDEA/SHEA	ACG	ESCMID	Current Review
Primary Prophylaxis to Prevent an Initial CDI Episode
Probiotics for primary prevention	Insufficient evidence	Recommends against	Not routinely recommended	Optimal role to be defined in populations with >5% risk of CDI
Antimicrobial prophylaxis	Not specifically addressed	Not specifically addressed	Not routinely recommended	To be considered in patients with sufficiently high baseline risk
PPI Discontinuation	Insufficient evidence to recommend discontinuation as a prevention measure	Recommends against discontinuation if an appropriate indication exists	Use should be reviewed	Ensure PPIs have a valid indication Used cautiously in high-risk patients
Strategies to Prevent Recurrent CDI episodes
Antimicrobial prophylaxis	Insufficient evidence to recommend suppressive or prophylactic agents	Suppressive vancomycin may be used in patients who cannot undergo or fail FMT and require frequent antibiotics; vancomycin prophylaxis may be considered during antibiotic use in patients with CDI history who are at high risk of recurrence	Prophylactic therapy may be warranted in select patients with multiple recurrences	Considered on a case-by-case basis
FMT	≥2 recurrences	≥2 recurrences	≥2 recurrences	Current recommendation is ≥2 recurrences. Role in primary CDI is of future interest
Bezlotoxumab	Recurrent infection in the last 6 months	Considered in patients at high risk for recurrence	First and subsequent recurrences	Main advantage is that it can be administered during antibiotic therapy. Its comparative effectiveness to FMT is unknown