C. dif Flashcards
Discribe Clostridioides difficile
- Gram positive
- Spore forming
- Anaerobic bacillus
How is C. dif transmitted
-Fecal oral route
Major abx that can lead to a C. dif infection
- Clindamycin
- Cephalosporins
- Fluoroquinolones
C. dif risk factors
- Recent abx use
- Elderly
- Hospital stay
- Immunocompromised
- Laxative use
- Alterations in gut pH
Diagnosis of C. dif
> /= 3 unformed stools in 24hrs
-Positive EIA
Who do we NOT test for C. dif
- Asymptomatic patients
- For cure
When do we use a test in addition to EIA
- If EIA comes back inconclusive (+/-)
- Then use PCR to confirm results
Management of C. dif
- Discontinue offending agent if possible
- Fluid and electrolyte replacement
- Avoid antimotility agents
C. dif infection control
- Wash your hands (not just gel)
- Use chlorine containing cleaners or other sporadical agents
Criteria for non-sever C. dif
-WBC < 15
AND
-SCr < 1.5
Criteria for sever C. dif
-WBC > 15
OR
-SCr > 1.5
Criteria for Fulminent C. dif
- Hypotension
- Shock
- Toxic megacolon
- Perforation
Treatment options for non-sever to sever C. dif
-Vanco 125mg po qid
or
-FDX 200mg po bid
-Duration 10 days
Treatment for Fulminant C. dif
-Vanco 500mg po qid
Plus
-Metronidazole 500mg IV q8h
-Surgery is usually needed too
1st recurrence of C. dif
- FDX 200mg po bid x 10 days
- Vanco tapered and pulsed
