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Clostridioides difficile infection after antibiotics — SCE Geriatric Medicine MCQ

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HardInfectionClostridioides difficile infection after antibioticsSCE Geriatric Medicine

An 84-year-old man has diarrhoea and abdominal pain seven days after cefalexin for cellulitis. He is febrile, WCC is 18 ×10⁹/L, creatinine has risen to 180 micromol/L and stool toxin is positive for Clostridioides difficile. He takes lansoprazole and senna. What is the most appropriate management?

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Correct answer: E — Treat C. difficile infection and review unnecessary proton pump inhibitor and laxative use

This is symptomatic C. difficile infection with systemic features after antibiotics. Management includes appropriate CDI therapy, hydration, infection control and review of precipitating drugs such as unnecessary antibiotics and PPIs. Loperamide can precipitate toxic megacolon and should be avoided in acute CDI. The pearl is that medication review is part of infection management in older adults.

Reference: NICE NG199; UKHSA CDI guidance; BNF