C. diff

Question 1

Which antibiotics are most likely to cause C. difficile infection?

Answer 1

Clindamycin
Cephalopsporins
Co-amoxiclav
Quinolines
Aminopenicillins e.g., ampicillin, amoxicillin

Question 2

How do certain antibiotics cause C. diff infection?

Answer 2

Broad spectrum ab significantly impact gut flora allowing other bacteria such as C. diff to become established

Question 3

How is C. difficile infection treated?

Answer 3

1. If on antibiotics, stop unless essential. If essential, change to one with lower risk of causing C. diff.
2. Vancomycin oral 125mg qds for 10 days.
3. Fidaxomicin 200mg bd for 10 days.
4. Vancomycin 500mg qds for 10 days with or without metronidazole 500mg IV tds for 10 days.

Question 4

What are some symptoms of C. difficile infection?

Answer 4

Watery diarrhoea
Belly cramping and tenderness, can become swollen
Fever
Nausea

Question 5

Why is oral vancomycin first line over IV for C. diff?

Answer 5

C. diff infection is in the intestinal lumen, not systemic. Oral vancomycin has low systemic absorption so stays in gut/intestines and works better.

Question 6

How long does oral vancomycin treatment for C. diff take to resolve symptoms?

Answer 6

1-2 weeks.