C diff Flashcards
What is definition of C diff?
> 3 diarrhea a day for 2 days AND detection of Toxin A+B
What are features of C diff?
Gram positive, anaerobe,
Which people are at risk of C diff?
hospital, recent antibiotics in 3 months, old, Gi surgery, antacid
Which antibiotics have highest rate of C diff?
clindamycin, FQ, Cephalosporins (3rd +4th gen)
What is considered severe C diff?
Leukocytes above 15000 and/or Scr>1.5 x baseline
What is considered severe-complicated C diff?
hypotension, shocl, ileus (vomiting)
What is first line for mild-moderate C diff?
Vanco 125 mg po QID 10-14 days
OR fidaxomicin 200 BID x 10 days
OR Metronidazole 500 TID x 10 days
WHat is first line for severe uncomplicated C diff?
Vanco 125 mg po QID x 14 days
OR fidaxomicin 200 mg BID x 10 days
What is first line for severe complicated C diff?
Vanco 125-500 mg QID x 10-14 days with Metronidazole 500 mg q8
What to do if allergy to vanco?
go to fida
If the patient has ileus what is our option?
vanco enema
Is there a treatment change for the first recurrence of C diff?
NO
Is there a treatment change for the second recurrence of C diff? What is it?
Vanco as a prolonged taper or pulsed, Fecal transplant, MAB for toxin A and B
What are the mabs for the toxins?
A=actoxumab
B= Bezlotoxumab
What do we do for pediatric C diff?
Vanco 40mg/kg/day divided QID x 10 days max of 125mg/dose
