Is oral metronidazole no longer the standard initial treatment for C diff?

[Eyeball Tickler]

Hi guys,

Came across a UW question and learned that oral vanc is to be given for any severity of CDI. Metro only to be given if vanc or fidaxomicin not available?

Is this true and is it a new change? I always thought it was oral metro first. If it's a new change, will step 3 reflect this and we should answer oral vanc?

Thanks

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[Cryc_to_the_point]

Oral vancomycin has been the first line as long as I can recall (not long).

 

[Ismet]

Hi guys,

Came across a UW question and learned that oral vanc is to be given for any severity of CDI. Metro only to be given if vanc or fidaxomicin not available?

Is this true and is it a new change? I always thought it was oral metro first. If it's a new change, will step 3 reflect this and we should answer oral vanc?

Thanks

Oral vancomycin has been the first line as long as I can recall (not long).

It's new as of 2017, the new IDSA guidelines recommend vanc or fidaxomicin as first line for even mild C. diff. It used to be that vanc was first line for severe C. diff as it significantly lowered mortality, but now it looks like it has surpassed flagyl in efficacy as well for all severities. Plus in my world (kiddos), PO vanc tastes like cherry and PO flagyl tastes like chewing on a rusty piece of metal.

New Clostridium difficile Guidelines - SHEA

Not sure what that means for Step 3 but it would be 1 question if any. Go with the new guidelines I'd say.

 

[RedSoxSuck]

Hi guys,

Came across a UW question and learned that oral vanc is to be given for any severity of CDI. Metro only to be given if vanc or fidaxomicin not available?

Is this true and is it a new change? I always thought it was oral metro first. If it's a new change, will step 3 reflect this and we should answer oral vanc?

Thanks

Actually, I did the same uworld question this morning and I thought the same thing. I went through my old step 2 notes and old uworld notes, It was oral metro then oral metro and then vanco.