What is the treatment for a severe C. difficile infection?

What is the treatment for a severe C. difficile infection?

• A. Vancomycin PO
• B. Metronidazole PO
• C. Fidaxomicin
• D. Probiotics

Answer: (A)

Severe C. difficile infection is treated with an antibiotic that delivers high concentrations directly to the colon where the bacteria are. Oral vancomycin fits that goal because it stays in the gut and achieves strong intraluminal activity, leading to better cure rates in severe disease. Metronidazole, while useful in milder cases or when other drugs aren’t available, is less effective when the infection is severe and has fallen out of favor as first-line therapy for this reason. Fidaxomicin is an effective alternative and can be used, but it is more expensive and its overall advantage over vancomycin in severe cases isn’t universal, so vancomycin remains the standard initial choice. Probiotics do not reliably treat active CDI on their own and aren’t a substitute for targeted antibiotic therapy. The usual regimen is vancomycin taken by mouth, typically 125 mg four times daily for about 10 days, with adjustments if there are complications like ileus where additional strategies may be needed.

Severe C. difficile infection is treated with an antibiotic that delivers high concentrations directly to the colon where the bacteria are. Oral vancomycin fits that goal because it stays in the gut and achieves strong intraluminal activity, leading to better cure rates in severe disease. Metronidazole, while useful in milder cases or when other drugs aren’t available, is less effective when the infection is severe and has fallen out of favor as first-line therapy for this reason. Fidaxomicin is an effective alternative and can be used, but it is more expensive and its overall advantage over vancomycin in severe cases isn’t universal, so vancomycin remains the standard initial choice. Probiotics do not reliably treat active CDI on their own and aren’t a substitute for targeted antibiotic therapy. The usual regimen is vancomycin taken by mouth, typically 125 mg four times daily for about 10 days, with adjustments if there are complications like ileus where additional strategies may be needed.