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C. diff objectives

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Complications of C. diff

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6 years ago

Date created

Mar 1, 2020

Cards (14)

Section 1

(14 cards)

Complications of C. diff

Front

psuedomembranous colitis toxic megacolon, sepsis, colectomy, death

Back

Definition of non-severe CDI

Front

WBC <15,000 cells/mm3 and serum creatinine <1.5 mg/dL

Back

Place in therapy for bezlotoxumbad

Front

reduces recurrence of CDI in pts >18yo who are receiving additional antimicrobial therapy of CDI and at high risk for CDI recurrence

Back

treatment for 2nd recurrence of CDI

Front

pulsed/tapered vanco OR vanco 125 mg QID x10 days followed by rifaximin 400mg TID x20 days OR fidaxomicin 200mg BID x10 days OR fecal transplantation

Back

effective contact precautions and environmental cleaning strategies

Front

private rooms, gloves/gowns and dedicated equipment, handwashing with soap (Not alcohol), decontaminate with sodium hypochlorite

Back

treatment for 1st recurrence of CDI

Front

if metronidazole was previously used: vancomycin 125mg PO QID x10 days if vanco was previously used: use pulsed and tapered vanco OR fidaxomicin 200 mg BID x10 days

Back

Definition of fulminant CDI

Front

hypotension, shock, perforation

Back

Treatment of fulminant CDI

Front

if no complete ileus/no significant abdominal distension: vancomycin 125 mg PO or NG QID x10 days if complete ileus/toxic colitis, and/or significant abdominal distension: vancomycin 500 mg PO or NG QID + metronidazole 500mg IV TID

Back

Causative pathogen

Front

C. diff (NAP1/BI/027) - produces CDT binary toxin that increases duration and binding of toxin A and B, adherence to epithelium, and spore production - resistant to FQ, erythromycin and clindamycin

Back

Treatment of severe CDI

Front

vancomycin 125 mg PO QID x10 days fidaxomicin 200 mg BID x10 days no metronidazole

Back

Definition of severe CDI

Front

WBC >15,000 cells/mm3 OR serum creatinine >1.5 mg/dL

Back

major risk factors for C. diff

Front

Antimicrobial exposure in previous 1-8 weeks: clindamycin, ampicillin/amoxicillin. 2nd and 3rd gen cephs, FQ Others: advanced age, GI surgery, acid suppressive, recent bowel surgery, nasogastric tube feeding, chemotherapy, immunosuppression, lower concentrations of antibodies against toxin A and B

Back

Classic s/sx of C. diff

Front

profuse watery diarrhea with characteristic odor, fever, malaise, cramps, etc leukocytosis, elevated Scr, hypoalbuminemia, leukouria

Back

Treatment of non-severe CDI

Front

vancomycin 125 mg PO QID x10 days fidaxomicin 200 mg BID x10 days alternative: metronidazole 500mg (has too many ADR)

Back