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Antibiotic adverse effect — DGM MCQ

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ModeratePolypharmacyAntibiotic adverse effectDGM

An 85-year-old woman develops profuse diarrhoea after antibiotics for pneumonia. She is taking a proton pump inhibitor and has abdominal cramps. Temperature is 38.1°C and white cell count is raised. Current medicines include co-amoxiclav and lansoprazole. What is the most likely diagnosis?

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Correct answer: A — Clostridioides difficile infection

Recent broad-spectrum antibiotics, PPI use, fever and profuse diarrhoea suggest Clostridioides difficile infection. Overflow diarrhoea is usually associated with faecal loading, IBS and coeliac disease are chronic, and lactose intolerance lacks antibiotic association and systemic features. Antibiotic stewardship and PPI review can reduce risk.

Reference: NICE CKS diarrhoea antibiotic-associated; BNF