C. diff presentation

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C. diff presentation

  1. 1. Clostridium difficile
  2. 2. Incidence and Severity <ul><li>During the mid- and late 1990s, in the US, the incidence was 30 to 40 per 100,000 </li></ul><ul><li>Incidence increased to 50 per 100,000 in 2001 to 84 per 100,000 in 2005. </li></ul><ul><li>In Britain C. diff as the primary cause of death increased from 499 in 1999 to 3393 in 2006 </li></ul>
  3. 3. Metro vs vanc <ul><li>Metronidazole or oral vancomycin have the treatment of choice since the late 1970s </li></ul><ul><li>Before 2000, failure rates were around 3% for both therapies </li></ul><ul><li>But since, there have been significant increases in flagyl failure (18.2%) </li></ul><ul><li>Metronidazole is the first line treatment for mild infections, but vancomycin should be used for severe treatment </li></ul>
  4. 6. Management of Recurrence <ul><li>Ultimate goal of treatment is to discontinue all antibiotics </li></ul><ul><li>Not all patients in whom recurrent diarrhea develops have recurrent C. diff </li></ul><ul><ul><li>Posinfectious irritable bowel </li></ul></ul><ul><ul><li>Microscopic colitis </li></ul></ul><ul><li>Positive toxin with minimal or no symptoms should not prompt treatment </li></ul><ul><li>Since C. diff is rarely resistant to metronidazole or vancomycin, diarrhea despite therapy should increase suspicion for another etiology </li></ul>

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