Pharm C. diff treatment Flashcards Preview

GI & Liver Fall 2013 CBD > Pharm C. diff treatment > Flashcards

Flashcards in Pharm C. diff treatment Deck (11):
1

What is the toxin produced by C diff NAP-1/027?

lacks tcdC - expression normally negatively regulates regulates transcription and therefore production of the toxin. Toxins A & B go up.

2

How bad is C diff epidemiologically?

7x all other GI infections combined

3

What strain of C diff is linked to increased disease severity & mortality?

NAP1 Ribotype 027

4

antimicrobial combinations that can bring on c diff infection? (2 sets of 2)

clindamycin - penicillins
cephalosporins - fluoroquinalones

5

Risk factors for c diff infection? (5)

exposure to antimicrobial combinations/mult
hospitalization
age (65-84)
IBD
Gastric acid suppression

6

Are PPIs a risk factor for C diff?

no

7

C diff dx

clinical suspicion, immunoassays to toxins A & B

8

DOC for C diff

oral metronidazole for mild or moderate
oral vanc for severe or pregnant/lacating
high dose vanc oral or IV for complicated
Rectal vanc for ileus, abd distention

9

why shouldn't metronidazole be used in preg/lact?

crosses placenta, expressed in milk. unknown effects.

10

fidaxomicin [DIFICID]

novel mechanism of bacterial RNA polymerase inhibitor. lack of cross-resistance. Remains in GI tract. Adverse GI events comparable to vanc

provides less recurrence than vanc therapy, but very expensive. Useful if recurrence costs would overcome drug cost.

11

is it good to put poop from one person into another?

Yep, seems so.