A 68-year-old man on ICU develops profuse watery diarrhoea after 14 days of broad-spectrum antibiotics. C. difficile toxin is positive. He has develop...

Question

A 68-year-old man on ICU develops profuse watery diarrhoea after 14 days of broad-spectrum antibiotics. C. difficile toxin is positive. He has developed toxic megacolon (colonic diameter 8 cm on abdominal radiograph) with rising lactate (4.2 mmol/L) and WCC 28 × 10⁹/L. What is the most appropriate management?

Accepted Answer

Oral vancomycin 500 mg QDS plus IV metronidazole 500 mg TDS and urgent surgical review

Answer

Oral vancomycin 125 mg QDS

Answer

IV metronidazole 500 mg TDS alone

Answer

Oral fidaxomicin 200 mg BD

Answer

Faecal microbiota transplantation

uk-fficm MCQ (SBA): Fulminant C. difficile Infection