Codeveloping a Clinical Pathway for Recurrent Clostridioides difficile Infection With Primary Care Providers: User-Centered Design Study

Background

Clostridioides difficile infection (CDI) is the most common cause of health care-associated infectious diarrhea; however, variability in laboratory testing results in uncertainty in diagnosis and clinical decision-making. Recurrent CDI (rCDI), defined as the return of infection following initial treatment, continues to present significant clinical challenges due to limited therapeutic options. Although health care providers are familiar with vancomycin as first-line therapy for CDI, many are less familiar with fecal microbiota transplantation (FMT), despite its recommendation in clinical guidelines for rCDI management. Consequently, primary care providers (PCPs) may experience uncertainty regarding diagnostic test interpretation, treatment selection, and referral for FMT, highlighting the need for practical clinical tools to support evidence-based management.