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Infectious Diseases


Answer 4
  1. Add metronidazole to the current regimen. 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 patient’s colitis and definitely would not be appropriate in this patient with bacteremia and neutropenia with gastrointestinal mucosal breakdown.2

    REFERENCE
    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; 34:730–51.

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