Fast Five Quiz: Clostridium difficile

B.S. Anand, MD

Disclosures

August 05, 2019

According to the guidelines on C difficile infection in surgical patients from the WSES, total colectomy should be considered in patients with fulminant colitis. However, diverting loop ileostomy with colonic lavage is a useful alternative. Fulminant colitis should be treated with high-dose vancomycin (500 mg every 6 hours)—orally, via enema, or both—in combination with intravenous metronidazole (500 mg every 8 hours). Use of oral metronidazole should be limited to the initial treatment of mild to moderate C difficile infection.

The WSES guidelines also state that although GDH testing is sensitive, it does not differentiate between toxigenic and nontoxigenic strains. The recommendations also specify that C difficile culture is rarely performed as a diagnostic test. Although sensitive, it is slow and is recommended for epidemiologic typing and characterization of strains.

Read more information on C difficile infection guidelines.

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