po vanc dose

 Q: High dose of oral vancomycin is more effective in cases of life-threatening severe clostridioides difficile infection? 

A) True 

B) False

 

Answer: B

Overall vancomycin is found to be more effective and shown to reduced 30-day mortality when compared with metronidazole in severe clostridioides difficile infection. Said that the outcome is similar between a standard dosing of vancomycin or higher dosing (125 mg vs 500 mg four times daily).

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References:

1. Fekety R, Silva J, Kauffman C, et al. Treatment of antibiotic-associated Clostridium difficile colitis with oral vancomycin: comparison of two dosage regimens. Am J Med 1989; 86:15. 

2. Stevens VW, Nelson RE, Schwab-Daugherty EM, et al. Comparative Effectiveness of Vancomycin and Metronidazole for the Prevention of Recurrence and Death in Patients With Clostridium difficile Infection. JAMA Intern Med 2017; 177:546.