Metronidazole and vancomycin are both appropriate treatments for C. difficile colitis, but only metronidazole is effective both orally and parenterally. IV vancomycin is not effective against C. difficile colitis. Discontinuing antibiotics would not treat this patients colitis and definitely would not be appropriate in this patient with bacteremia and neutropenia with gastrointestinal mucosal breakdown.2
- Add metronidazole to the current regimen.
2. Hughes WT, Armstrong D, Bodey GP, et al. 2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer. Clin Infect Dis 2002;
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Seminars in Medical Practice
Hospital Physician Board Review Manuals
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Updated 11/20/08 nvf