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Clostridioides difficile Infection — ESEGH MCQ

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HardClostridioides difficile Infection - Focused UpdateClostridioides difficile InfectionESEGH

A 74-year-old develops a first episode of toxin-positive C. difficile diarrhoea after co-amoxiclav. He is haemodynamically stable, creatinine is unchanged and there is no ileus. According to current NICE guidance, which antimicrobial is first line?

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Reveal the answer and explanation

Correct answer: D — Oral vancomycin 125 mg four times daily for 10 days

NICE recommends oral vancomycin 125 mg four times daily for 10 days for a first episode of mild, moderate or severe C. difficile infection. Fidaxomicin is second line for a first episode when vancomycin is ineffective. Metronidazole is not first-line treatment. Essential inciting antibiotics and unnecessary proton-pump inhibitors should also be reviewed.

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