Clostridioides difficile Infection — Medical Practice MCQ

Instant feedback + full explanation. One question, done properly.

EasyInfectious DiseasesClostridioides difficile Infection

A 62-year-old with first-episode nonsevere Clostridioides difficile infection (WBC 11,200/µL, creatinine 80 µmol/L) asks about treatment. Which is the preferred therapy?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Vancomycin 125 mg orally four times daily for 10 days

This is a first episode of nonsevere C. difficile infection: WBC 11.2 × 10^9/L is below the severe threshold of 15 × 10^9/L and creatinine is not acutely raised. Under current UK NICE guidance, the preferred first-line treatment for a first episode of mild, moderate, or severe C. difficile infection in adults is oral vancomycin 125 mg four times daily for 10 days. Fidaxomicin is used if vancomycin is ineffective or for selected recurrent episodes. Metronidazole is no longer the preferred first-line option in UK practice. Probiotics alone are not treatment, and loperamide should not be offered in suspected or confirmed C. difficile infection.

Reference: NICE Guideline NG199: Clostridioides difficile infection: antimicrobial prescribing, 2021. https://www.nice.org.uk/guidance/ng199/chapter/Recommendations