What is the recommended oral antibiotic therapy for pseudomembranous colitis?

What is the recommended oral antibiotic therapy for pseudomembranous colitis?

• A. IV Vancomycin
• B. Oral Metronidazole
• C. PO Vancomycin
• D. Oral Amoxicillin

Answer: (C)

The best approach targets the infection right in the colon. Pseudomembranous colitis from C. difficile is a problem in the gut lumen, so you want an antibiotic that stays in or acts within the gastrointestinal tract and reaches high concentrations there. Oral vancomycin fits this perfectly: it isn’t significantly absorbed into the bloodstream, so it stays in the GI tract and achieves high colonic concentrations to eradicate C. difficile. By contrast, giving vancomycin by IV won't deliver enough drug to the colon, because it isn’t absorbed from the gut. Metronidazole has fallen out of favor for most cases due to lower efficacy, and amoxicillin is not an appropriate therapy for CDI. Therefore, oral vancomycin is the recommended oral antibiotic therapy.

The best approach targets the infection right in the colon. Pseudomembranous colitis from C. difficile is a problem in the gut lumen, so you want an antibiotic that stays in or acts within the gastrointestinal tract and reaches high concentrations there. Oral vancomycin fits this perfectly: it isn’t significantly absorbed into the bloodstream, so it stays in the GI tract and achieves high colonic concentrations to eradicate C. difficile. By contrast, giving vancomycin by IV won't deliver enough drug to the colon, because it isn’t absorbed from the gut. Metronidazole has fallen out of favor for most cases due to lower efficacy, and amoxicillin is not an appropriate therapy for CDI. Therefore, oral vancomycin is the recommended oral antibiotic therapy.