Clostridium Difficile

Question 1

What is Clostridium Difficile?

Answer 1

Is a bacterium that can infect the bowel.

Question 2

What toxins do C.Diff release?(2)

Answer 2

Enterotoxin

Cytotoxin

Question 3

Who gets infected by C Diff?

Answer 3

People who have been treated with any antibiotics.

Question 4

How does C Diff present?

Answer 4

• Diarrhoea (maybe blood)
• Abdominal Pain (meyb)
• Fever (mebbe)
• Psuedomembranous Colitis (PMC)

Question 5

What investigations confirm diagnosis of Clostridium Difficile? (2)

Answer 5

• Raised White Cell Count

- Diarrheal symptoms MUST be PRESENT

Question 6

What is the first line treatments for C Difficile?

Answer 6

Oral Metronidazole

if no severity markers

Question 7

What treatment do we give if the patient has two or more severity markers?

Answer 7

Oral Vancomycin

Question 8

What do we give to patients suffering from C Diff if metronidazole nor vancomycin does not prevent a second episode?

Answer 8

Oral Fidaxomicin

Question 9

What surgical options are available for people with C Diff?

Answer 9

Fecal Transplant

Question 10

What drugs do we avoid to people at risk of developing C Difficile? (4)

Answer 10

The 4Cs:

Co-amoxiclav
Cephalosporin
Clarithromycin
Clindamycin

Question 11

How can GPs prevent C Difficile occurrence? (5)

Answer 11

• Avoid the 4Cs
• Wash hands between patients
• Antimicrobial Management Team to develop a local Abx policy
• Reduction in broad spectrum Abx Prescribing