Optimal Treatment for Recurrent Clostridium Difficile

Inclusion Criteria: * Informed consent obtained and signed * Age \> 18 * If female, participant must not be pregnant or nursing * Negative pregnancy test required for females \<61 years of age or without prior hysterectomy * Confirmed current diagnosis of CDI, determined by having * \>3 loose or semi-formed stools for participants over 24 hours AND * Positive stool assay for C. difficile * EIA positive for toxin A/B; or * Cytotoxin assay; or * Nucleic Acid Amplification Test (NAAT, PCR or LAMP) based detection of toxigenic C. difficile * Current episode represents the first recurrent episode of CDI within 3 months of the primary CDI episode in a patient who has not had CDI in the 3 months prior to the primary episode OR a second recurrent CDI episode occurring within 3 months of the first recurrent episode, as defined above * At least one of the previous CDI episodes must have been confirmed by a stool assay for C. difficile Exclusion Criteria: * Inability to provide informed consent * Inability to take oral capsules * Receipt of \>72 hours of antibiotics considered effective in the treatment of CDI, including: * metronidazole * vancomycin * fidaxomicin * nitazoxanide * rifaximin * Prior infusion of bezlotoxumab within the previous 6 months * Known presence of fulminant CDI, including hypotension, severe ileus or GI obstruction or incipient toxic megacolon * Receipt of more than a single course of oral vancomycin, fidaxomicin, or a vancomycin ta…