Clostridioides difficile Flashcards
(16 cards)
What is the main mechanism by which C. difficile causes diarrhoea?
Toxin production that damages the colon lining.
Name 4 antibiotic classes most commonly associated with C. difficile infection.
Clindamycin, cephalosporins (3rd/4th gen), fluoroquinolones, broad-spectrum penicillins.
What are key non-antibiotic risk factors for C. difficile infection?
Use of PPIs, age >65, prolonged hospitalisation, comorbidities, previous infection, exposure to infected patients.
What defines a mild case of C. difficile infection?
<3 loose stools/day and normal white cell count (WCC).
How is a relapse of C. difficile defined?
Recurrence of symptoms within 12 weeks of resolution.
What is the first-line antibiotic for a first episode (any severity) of C. difficile in adults?
Vancomycin 125 mg PO QDS for 10 days.
If vancomycin fails in a first episode, what is the next treatment option?
Fidaxomicin 200 mg PO BD for 10 days.
What combination is used for life-threatening C. difficile infection?
Vancomycin 500 mg PO QDS + IV Metronidazole 500 mg TDS.
What should you not offer to prevent C. difficile infection?
Antibiotics, prebiotics, or probiotics.
When should a faecal microbiota transplant be considered?
After ≥2 previous episodes of C. difficile infection in adults.
Why should loperamide be avoided in C. difficile infection?
It can worsen colonic toxicity by delaying toxin clearance.
What is a key difference in the spectrum of activity between vancomycin and fidaxomicin?
Fidaxomicin is narrow-spectrum and preserves gut flora better than vancomycin.
In what scenario is fidaxomicin preferred over vancomycin?
In relapse of C. difficile infection within 12 weeks of previous resolution.
What are the BNF-listed cautions for vancomycin use?
Renal impairment, hearing loss (due to risk of ototoxicity), and elderly patients.
Are vancomycin and fidaxomicin systemically absorbed when given orally?
No – they act locally in the gut with minimal systemic absorption.
Why should PPIs be reviewed and potentially stopped in patients with C. difficile?
PPIs may increase the risk of C. difficile infection by reducing gastric acidity.
