Posted in Flagyl on July 9, 2015

A diligent on your ward is being treated with ceftriaxone for pneumonia. Two days subsequent to antibiotic administration, she begins to actual observation watery diarrhea, but no fever.Clostridium difficile PCR testing adhering a stool sample comes back tenacious. The patient’s CBC, lytes and creatinine are inside normal limits.

What is your first letter treatment for this patient?
This resigned has a mild C. difficile contamination.
The treatment indicated is Metronidazole 500mg PO TID notwithstanding 10-14days.
Second line treatment is Vancomycin 125mg PO QID conducive to 10-14days.

How would your administration change if the patient developed a heat, an elevated WBC count, and hypotension?
A persevering with C. difficile presenting with fever, an elevated WBC count, and hypotension is exhibiting morose/complicated C. difficile infection.
The usage in this case would be metronidazole 500mg IV q8h AND vancomycin 125-500mg PO QID.

Bagdasarian N, Rao K and Malani PN. Diagnosis and management of Clostridium difficile in adults: a systemic re-examination. JAMA. 2015;313:398-408.

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