Infectious Diseases II: C. Diff

Question 1

C. diff classifcation

Answer 1

Gram + anaerobic rod
spore-forming
Some release toxins, which causes colitis

Question 2

C. diff infection symptoms

Answer 2

cramps
profuse diarrhea (can be bloody)
fever

Question 3

Antimotility agents (loperamide) should not be used for C. diff diarrhea (t/f)

Answer 3

TRUE

can increase risk of toxic megacolon

Question 4

New first line treatment for mild-moderate c. diff infection according to recently updated guidelines

Answer 4

vancomycin 125 mg PO QID or fidaxomicin 200 mg PO BID for 10 days.

Question 5

Definition of severe C. diff infection

Answer 5

WBC > 15,000

or Scr 1.5x baseline

Question 6

First line treatment for severe C. diff infection

Answer 6

vanco 125 mg QID x10-14 days

Question 7

Treatment options for 1st recurrence of c. diff according to recently updated guidelines

Answer 7

Use vanco taper/pulse dose or fidaxomicin 200 mg BID x 10 days if vanco was used for 1st infection

Question 8

What drug is no longer recommended for c. diff treatment?

Answer 8

Metronidazole po

Question 9

Treatment for severe, complicated disease (hypotension, shock, ileus)

Answer 9

vanco 500 mg QID + IV metronidazole 500 mg q8h

Question 10

Cause of Traveler’s Diarrhea

Answer 10

from ingestion of contaiminated food or water

can be caused by E. coli, shigella, salmonella, protozoa

Question 11

Symptoms of traveler’s diarrhea

Answer 11

Loose stools
abdominal pain/cramps
fever
dysentery (bloody diarrhea)

Question 12

Preferred treatment for Traveler’s diarrhea

Answer 12

If fever or bloody diarrhea:

azithromycin 1g x1, 500 mg daily x1-3 days

Question 13

Other options for Traveler’s diarrhea

Answer 13

Cipro
Levofloxacin
Rifaximin
Metronidazole, tinidazole reserved for protozoal infections