infectious diarrhea and CDID

Question 1

indications for antibiotics in acute infectious diarrhea

Answer 1

fever with bloody diarrhea 
mucoid stools 
severe abdominal pain/cramps/tenderness 
sepsis 
immunocompromised

Question 2

acute infectious diarrhea treatment

Answer 2

ceftriaxone IV 2g Q24h
ciprofloxacin PO 500mg BD
duration: 3-5d

Question 3

non-severe initial episode treatment in CDID

Answer 3

vancomycin PO 125mg QDS
fidaxomicin PO 200mg BD

metronidazole PO 400mg TDS

10d up to 14d

Question 4

severe initial episode treatment in CDID

Answer 4

vancomycin PO 125mg QDS
fidaxomicin PO 200mg BD

10d up to 14d

Question 5

fulminant initial episode in CDID

Answer 5

metronidazole IV 500mg Q8h PLUS vancomycin PO 500mg QDS

w(o) vancomycin PR 500mg QDS

Question 6

first recurrence treatment, metronidazole initial episode treatment in CDID

Answer 6

vancomycin PO 125mg QDS 10d

Question 7

first recurrence, first line initial episode treatment in CDID

Answer 7

fidaxomicin PO 200mg BD 10d

vancomycin PO taper

Question 8

second/subsequent recurrence in CDID

Answer 8

fidaxomicin PO 200mg BD 10d
vancomycin PO taper
vancomycin PO 125mg QDS 10d followed by rifaximin PO 300mg TDS 20d
fecal microbiota transplant

Question 9

healthcare risk factors for CDID

Answer 9

prior hospitalisation
duration of hospitalisation
residence in nursing home or long-term care facilities

Question 10

pharmacotherapy risk factors for CDID

Answer 10

systemic antibiotics - no of agents, duration of therapy
high risk antibiotics: clindamycin, FQs, 2nd or higher cephalosporins
gastric acid suppressive therapy

Question 11

patient related risk factors for CDID

Answer 11

multiple or severe comorbidities
immunosuppression
> 65y
history of CDI

Question 12

CDID diagnosis

Answer 12

clinical suspicion

confirmatory test or finding