C. difficile Prevention — SCE Infectious Diseases MCQ

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

EasyAntimicrobial StewardshipC. difficile PreventionSCE Infectious Diseases

A hospital is experiencing a sustained increase in C. difficile cases. The antimicrobial stewardship team proposes restricting a specific antibiotic class known to be the highest-risk for C. difficile. Which class should be prioritised for restriction?

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

Reveal the answer and explanation

Correct answer: C — Fluoroquinolones (Ciprofloxacin, Levofloxacin, Moxifloxacin)

Fluoroquinolones are the antibiotic class most strongly associated with C. difficile infection, particularly with the hypervirulent ribotype 027 (NAP1/BI). Restriction of fluoroquinolone prescribing has been demonstrated to reduce CDI rates across multiple NHS hospitals. Broad-spectrum cephalosporins (particularly 2nd and 3rd generation) and Clindamycin are also high-risk. Narrower-spectrum agents (Nitrofurantoin, Trimethoprim, Doxycycline, Pivmecillinam) are low-risk for CDI and should be preferentially used where clinically appropriate.

Reference: NICE NG15 2015 – Antimicrobial stewardship; UKHSA 2024 – C. difficile reduction strategy