NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

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Following a second episode of C. diff infection, what treatment approach is recommended?

FDX or Vancomycin standard + pulse/tapered course
Vanco std + rifaximin x 20 days
Fecal microbiota transplantation
Vancomycin PO QID x10 days

The correct answer is: FDX or Vancomycin standard + pulse/tapered course

Following a second episode of C. diff infection, the recommended treatment approach is to use fidaxomicin (FDX) or vancomycin as the standard treatment with a pulse/tapered course. This approach is necessary to help combat the recurrence of C. diff infection successfully. Fidaxomicin or vancomycin is preferred over other antibiotics due to their efficacy in treating C. diff infection. Additionally, the pulse/tapered course helps to reduce the risk of recurrence by gradually reducing the dose, rather than stopping abruptly, which can lead to a higher likelihood of the infection reoccurring. As for the other options: - Option B suggests using vancomycin with rifaximin, which is not the standard approach recommended for a second episode of C. diff infection. - Option C, fecal microbiota transplantation, is typically considered for recurrent episodes of C. diff infection that do not respond to standard antibiotic treatment. - Option D recommends using vancomycin PO QID x10 days, which is a shorter course compared to the pulse/tapered approach recommended for a second C. diff infection episode.