Gastroenterology & Hepatology — Flashcards

Flashcard 531: C. diff stool antigen testing shows _____

Answer: exposure to C. diff

Flashcard 532: What is the diagnostic test for C. diff infection? _____

Answer: C. diff toxin stool test

Flashcard 533: Historically, it was thought that _____ was responsible for causing C. diff infections Currently the no. 1 cause of C. diff infections is 2nd and 3rd generation cephalosporins

Answer: Clindamycin

Flashcard 534: Aside from antibiotics, what other medication increases risk of C. diff? _____

Answer: PPIs

Flashcard 535: _____ may be considered in patients who have had at least two recurrences of C.diff infection (i.e. 3rd episode or more)

Answer: Faecal transplant

Flashcard 536: What is the management of life-threatening C. diff? _____ & Oral vancomycin AND IV metronidazole

Answer: Stop current ABX if possible

Flashcard 537: What is the management of recurrent C. diff after _____? Stop current ABX if possible & Oral vancomycin OR fidaxomicin

Answer: 12 weeks

Flashcard 538: What is the management of recurrent C. diff within _____? Stop current ABX if possible & Oral fidaxomicin

Answer: 12 weeks

Extra: According to IDSA/SHEA guidelines, the first recurrence of C. diff (within 8-12 weeks) is ideally managed with Fidaxomicin (200 mg BID for 10 days) if Vancomycin was used for the initial episode. If Fidaxomicin was used initially, Vancomycin in a tapered/pulsed regimen is an alternative.

Flashcard 539: C. diff is a gram-_____

Answer: positive rod

Flashcard 540: What is the management of first episode *C. difficile* infection? _____ & Oral Vancomycin (or Fidaxomicin) for 10 days

Answer: Stop inciting antibiotics

Extra: According to current IDSA/SHEA guidelines, both **Oral Vancomycin** (125 mg QID) and **Fidaxomicin** are preferred over Metronidazole for the first episode of C. diff, regardless of severity (non-severe vs. severe). Metronidazole is now only used if the others are unavailable.