Flashcards in Pharm C. diff treatment Deck (11):
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.
How bad is C diff epidemiologically?
7x all other GI infections combined
What strain of C diff is linked to increased disease severity & mortality?
NAP1 Ribotype 027
antimicrobial combinations that can bring on c diff infection? (2 sets of 2)
clindamycin - penicillins
cephalosporins - fluoroquinalones
Risk factors for c diff infection? (5)
exposure to antimicrobial combinations/mult
Gastric acid suppression
Are PPIs a risk factor for C diff?
C diff dx
clinical suspicion, immunoassays to toxins A & B
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
why shouldn't metronidazole be used in preg/lact?
crosses placenta, expressed in milk. unknown effects.
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.