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Antibiotic-associated diarrhoea — GPhC CRA MCQ

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HardGI TherapeuticsAntibiotic-associated diarrhoeaGPhC CRA

A 74-year-old man asks for loperamide after 2 days of diarrhoea. He completed clindamycin 6 days ago after dental treatment and now has six watery stools daily with cramping and temperature 38.1C. He looks dry and light-headed. What is the most appropriate action?

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Correct answer: E — refer urgently for assessment of possible antibiotic-associated colitis

Recent clindamycin exposure followed by fever, frequent watery diarrhoea and dehydration raises concern for Clostridioides difficile infection. Loperamide is inappropriate where infective or inflammatory diarrhoea is suspected because it may worsen outcomes. Urgent clinical assessment and stool testing may be needed. Restarting clindamycin would be unsafe.

Reference: BNF; NICE CKS: Diarrhoea