The incidence of Clostridium difficile infection (CDI) has increased throughout Canada, Europe, and the US in the last decade, including more cases in young, healthy persons and postpartum women [1–4]. It remains a clinically important nosocomial pathogen, with an increasing incidence of community-acquired disease. Estimates indicate an overall disease incidence of 20–30 cases per 100000 persons with approximately 20–25% of cases occurring in the community [2,3]. The most common and important risk factor is the use of broad-spectrum antibiotics or concomitant use of multiple antimicrobials for protracted courses [5–7]. Other recognized risk factors for C difficile-associated diarrhea (CDAD) include advanced age (≥65 years), female sex, recent solid organ transplantation or gastrointestinal (GI) surgery, use of immunosuppressive drugs or acid suppressive medications, prolonged hospitalization, malnutrition, nasogastric tube feeding, and the presence of multiple comorbidities [8–12]. With increasing incidence, much attention has focused on optimizing the treatment of CDI, specifically reducing recurrence. Disease recurrence, or a return of symptoms after initial treatment, may be caused by relapse of initial infection or reinfection and occurs in approximately 20–25% of patients .