C. diff

Question 1

Risk Factors

Answer 1

-Use of abx
-GI surgery
-65+
-PPI/H2RA use
-Recent hospital stay
-Hx of C. diff
-Immunocompromised

HIC GAP 6

Question 2

SX

Answer 2

-Unexplained and new onset of 3+ unformed stools in 24 hours
-Abdominal pain
-NV
-Leukocytosis
-Hemo instability

Labs
o NAAT alone, or
o NAAT + toxin, or
o NAAT + GDH + toxin, or
o GDH + toxin

Question 3

3 meds for TX

Answer 3

-Fidaxomicin
-Vancomycin
-Metronidazole

Question 4

Fidaxomicin AE/CI

Answer 4

FIDA and GAVAN
-Nausea/vomiting
-Abdominal pain
-GI bleeding
-Anemia

CI
-Hypersensitivity

Question 5

Vancomycin AE/CI

Answer 5

F HAND
-Nausea
-Abdominal pain
-Dysgeusia
-HA
-Flatulence

CI:
-Hypersensitivity

Question 6

Metronidazole AE/CI

Answer 6

DAMNNH
-Metallic taste, nausea, HA
-Abdominal pain
-Disulfiram rxn (no alc for up to 3 days after)
-Neuro sx

CI:
-Hypersensitivity
-Pregnancy 1st trimester

Question 7

Preferred in Initial TX

Answer 7

FDX 200 BID 10 days
then
VANC 125 QID 10 days
then
MTZ 500 TID 10-14 days

Question 8

Preferred in Recurrent Disease

Answer 8

FDX 200 mg BID x 10 days OR BID x 5 days f/b QOD x 20 days

VANC PO tapered and pulsed regimen

VANC 125 mg PO QID x 10 days

MTZ concomitantly with VAN course consideration

Adjunctive therapy: BEZLO 10 mg/kg IV x 1 with SOC

Question 9

Preferred in Fulminant

Answer 9

-Hypotension, shock, ileus, or megacolon

= VANC 500 QID

-Can add PR instillation if ileum

Concomitant use of MTZ 500 QID or PR VANC

Question 10

Prevention TX

Answer 10

-Fecal microbiota
-BELZO