Which of the following is the drug of choice for antibiotic associated pseudomembranous enterocolitis?
**Core Concept**
Pseudomembranous enterocolitis, also known as Clostridioides difficile (C. difficile) infection, is a bacterial infection of the colon caused by the overgrowth of C. difficile. This condition often occurs after antibiotic use, which disrupts the normal gut microbiota and allows C. difficile to colonize and produce toxins.
**Why the Correct Answer is Right**
Vancomycin is the drug of choice for treating C. difficile infection because it is a bactericidal antibiotic that is effective against C. difficile. Vancomycin acts by inhibiting cell wall synthesis in C. difficile, ultimately leading to cell lysis and death. In addition, vancomycin is not absorbed from the gastrointestinal tract, allowing it to remain in the colon and target C. difficile directly. Oral vancomycin is administered to treat C. difficile infection because it can reach high concentrations in the colon, where the infection occurs.
**Why Each Wrong Option is Incorrect**
**Option A:** Metronidazole is an alternative treatment for C. difficile infection but is generally reserved for mild cases or patients who cannot tolerate vancomycin. It is not the drug of choice.
**Option B:** Ciprofloxacin is a broad-spectrum antibiotic that may actually contribute to the development of C. difficile infection by disrupting the normal gut microbiota.
**Option C:** Flagyl is another name for metronidazole, which is an alternative treatment for C. difficile infection but is not the drug of choice.
**Clinical Pearl / High-Yield Fact**
It is essential to discontinue the offending antibiotic and initiate treatment with oral vancomycin as soon as possible in patients with suspected C. difficile infection. Early treatment can help prevent complications and improve outcomes.
**Correct Answer:** C. Vancomycin