C diff

Question 1

Which abx are most commonly associated with C diff?

Answer 1

penicillin: levofloxacin
clindamycin
cephalosporins

Question 2

Why is incidence of C diff increasing?

Answer 2

older patients or immunocompromised pts on steroids, chemo, abx
new strain resistant to toxins
overuse of abx has caused mutated strains

Question 3

What abx can be used if necessary to eradicate C diff?

Answer 3

metronidazole

vancomycin

Question 4

How do you diagnose C diff?

Answer 4

ELISA - can detect A and B toxins
PCR - can tell you if you are a carrier, but not if you have active disease

**cultures are not used

Question 5

What’s the problem w PCR for C diff?

Answer 5

it can’t tell you if you are having active disease vs just an asymptomatic carrier

Question 6

What should be the first step in treatment of C diff?

Answer 6

stop the offending antimicrobial

differentiate b/w mild, moderate, severe disease

mild: metronidazole
severe: vancomycin
severe: vanco + metronidazole

Question 7

This is an antibiotic that may work better than vancomycin

Answer 7

Fidaxomicin

**actually no better than vanco, but lower relapse rate

Question 8

This is a “miraculous” treatment option for C diff infection

Answer 8

fecal transplant … infusion of healthy stool into someone else’s intestines

Question 9

If a patient has Cdiff & WBC’s > 15,000, what should you put him on?

Answer 9

vancomycin

Question 10

What can you do for a really bad case of pseudomembranous colitis?

Answer 10

colectomy!