Day 2- Gastrointestinal Infections Flashcards
What is the difference between Toxin A and Toxin B in C.Diff?
What is the greatest risk of medication induced C.diff?
What is c.diff colitis?
Toxin A leads to mucosal injury and activates neutrophils. Toxin B leads to C.diff virulence and is more potent than toxin A.
Clindamycin, Fluoroquinolones, Cephalosporins.
more severe, fever, malaise, high volume diarrhea(watery, bloody), WBC’s.
What is Pseudomembranous colitis?
What is the difference between severe and non severe C.diff?
How do you treat initial episode non severe C.diff?
systemic illness, severe mucosal destruction, expulsion of cellular debris, severe diarrhea.
Non-severe is Leukocytosis with WBC <15,000 AND SCr <1.5. Severe is flipped and Fulminant is hypotension, shock, ileus, megacolon.
Vancomycin or Fidaxomicin and sometimes Metronidazole. All PO
How do you treat initial episode severe C.diff?
How do you treat initial episode fulminant?
How do you classify first recurrence?
Vancomycin or Fidaxomicin. All PO
Vancomycin 500 mg PO/FT QID x 10 days, Vancomycin via rectal instillation, Metronidazole 500 mg IV q8h particulary if ileus is present in the last 2.
Occurs within 8 weeks of completion of therapy, same severity as prior infection, treatment did not eradicate spores.
How do you treat first recurrence?
How do you treat second or subsequent recurrences?
Vancomycin 125 mg QID x 10 days(if metronidazole used during initial episode), Vancomycin prolonged taper/pulse or Fidaxomicin 200 mg BID x 10 days(if vanco used 1st).
Vanco taper/pulse, Vancomycin + Rifaximin, Fidaxomicin, Fecal microbiata transplantation.
