Direct inoculation to cefoxitin-cycloserine-fructose agar and broth was compared with alcohol shock-chopped meat broth inoculation for optimal detection of Clostridium difficile in fecal samples. Alcohol shock is significantly more sensitive than cefoxitin-cycloserine-fructose agar or broth and may be the method of choice to detect C. difficile in asymptomatic carriers.