How do you approach management of patients with active RA and recurrent non-severe C.diff?

I think the question here is why the patient is experiencing recurrent C.diff. Is it true recurrence or it never fully clears? Any IgA deficiency? CVID?

I would do an immune deficiency work up- complements, immunoglobulines and flowcytometry, response to pneumococcal vaccine.

In parallel to the workup, I suggest getting an ID consult from a referral center about the definite treatment of the C. diff. Maybe the patient needs a fecal transplant.

Treatment-wise, I suggest to definitely avoid any ...