What is the recommended approach to testing for cure after C. difficile treatment?

• A. Test of cure is not recommended.
• B. Test of cure is recommended for all patients.
• C. Test only if symptoms persist.
• D. Test after completing a full antibiotic course regardless.

Answer: (A)

After treating C. difficile, you should not perform routine test-of-cure. Lab tests for C. difficile infection often remain positive even after symptoms have resolved because of ongoing shedding or colonization, and a positive result after therapy does not reliably indicate ongoing infection or predict relapse. Conversely, a patient who feels well can still have a chronic positive test without needing further treatment. The practical approach is to rely on clinical status: do not test routinely, but consider retesting only if symptoms persist or recur to evaluate for relapse or reinfection. This avoids unnecessary testing and treatment and reflects that resolution of symptoms, not a negative test, best indicates cure.