InfectionsMar 15, 2026
C. diff is unquestionably contagious. It spreads through a fecal-oral route, meaning spores from an infected person's stool end up on hands, surfaces, or objects, and someone else swallows them. What makes C. diff particularly stubborn is that its spores can survive on surfaces for months, turning rooms, toilets, and shared equipment into lasting reservoirs of infection.
But the part most people miss: you don't have to be visibly sick to spread it. A significant number of people carry toxigenic C. diff without any symptoms at all. These asymptomatic carriers shed spores and contaminate their surroundings, acting as silent sources of ongoing transmission in hospitals, long-term care facilities, and homes.
AntibioticsMar 15, 2026
The largest modern randomized trial on this topic found that methenamine hippurate, taken twice daily, was non-inferior to daily low-dose antibiotics for preventing recurrent UTIs over 12 months. The gap between them was real but small enough to fall within the study's predefined "close enough" threshold. The critical difference: methenamine hippurate has no known tendency to promote antimicrobial resistance, while months or years of prophylactic antibiotics certainly can.
Methenamine hippurate has been around for decades, but it's attracting renewed attention as antibiotic stewardship climbs the priority list. Clinical guidelines are starting to acknowledge the newer trial evidence, and for women stuck in the cycle of repeated infections and repeated prescriptions, it represents a genuinely different approach.
InfectionsMar 15, 2026
If you've ever had a urinary tract infection, you know the drill: the burning, the urgency, the constant feeling that you need to go. The first question on your mind is almost always the same. When will this be over?
The short answer: with antibiotics, most uncomplicated UTIs feel significantly better within a few days and are largely resolved within a week. But the longer answer depends on whether you get treatment, how quickly you start it, and how severe your infection is. This article will walk you through what the research shows about realistic timelines, what happens if you skip or delay antibiotics, and when your symptoms should prompt a call to your doctor.
AntibioticsMar 15, 2026
Fidaxomicin and vancomycin clear a C. difficile infection at roughly the same rate. Where fidaxomicin pulls ahead, and it's not subtle, is in what happens next: significantly fewer people relapse. If you've dealt with C. diff before, or if you're facing treatment decisions right now, that distinction between "cured" and "cured and staying that way" is the whole ballgame.
Fidaxomicin is a narrow-spectrum macrolide antibiotic taken by mouth. It barely gets absorbed into the bloodstream, which means it concentrates where C. diff actually lives: your gut. And because it's narrow-spectrum, it does far less collateral damage to your normal gut bacteria than older treatments. That preservation of your microbiome appears to be a big part of why recurrence rates drop.
