A 78-year-old woman develops profuse diarrhoea 6 days after co-amoxiclav for cellulitis. White cell count is 24 x 10^9/L, creatinine has doubled from

Question

A 78-year-old woman develops profuse diarrhoea 6 days after co-amoxiclav for cellulitis. White cell count is 24 x 10^9/L, creatinine has doubled from baseline and stool toxin assay is positive for Clostridioides difficile. She is not shocked and has no ileus. What is the most appropriate treatment?

Accepted Answer

Oral vancomycin with infection control precautions

Answer

Oral metronidazole as preferred first-line treatment for severe disease

Answer

No treatment because symptoms may settle after stopping antibiotics

Answer

Loperamide to reduce diarrhoea volume

Answer

Intravenous ceftriaxone for colitis

Severe Clostridioides difficile colitis — SCE Acute Medicine MCQ

A 78-year-old woman develops profuse diarrhoea 6 days after co-amoxiclav for cellulitis. White cell count is 24 x 10^9/L, creatinine has doubled from baseline and stool toxin assay is positive for Clostridioides difficile. She is not shocked and has no ileus. What is the most appropriate treatment?