Clostridium difficile – Part 4
The first-line treatment in a new onset case of C diff colitis is to stop the causative antibiotic. The first treatment drug usually administered is oral or intravenous metronidazole (Flagyl), which is effective in about 85% of cases. The second-line treatment drug is oral vancomycin. There is almost universal agreement that the
intravenous form of vancomycin should not be used to treat C diff colitis, as it is poorly absorbed by the gut and is ineffective in treating this condition.
If metronidazole and vancomycin are not effective, oral rifampin can be used. As with vancomycin, the intravenous form should not be used. In addition, cholestyramine powder can be used as an adjunctive treatment as it binds the C diff toxins. However, it should not be used with oral vancomycin as it will bind this antibiotic and render this treatment ineffective.
Copyright 2006 Insidesurgery.com