04-27-2009, 01:10 PM
A 53-year-old woman is receiving cephalosporin antibiotics for bronchitis. On the seventh day of an intended 10-day course, she develops severe watery diarrhea with cramps. She gives a history of frequently developing diarrhea whenever she receives antibiotics. She is well hydrated and afebrile, and has a normal leukocyte count and normal serum albumin. A proctosigmoidoscopy is unremarkable, and cytotoxin assay for Clostridium difficile is negative. She has leukocytes in the feces, and fecal culture is pending. Which of the following is the most appropriate next step in management?
A. Complete the intended antibiotic course, and add cultured yogurt
B. NPO, intravenous fluids, and avoid antiperistaltic agents
C. Prescribe oral metronidazole
D. Prescribe oral vancomycin
E. Stop the antibiotic and administer a combination of diphenoxylate and atropine
A. Complete the intended antibiotic course, and add cultured yogurt
B. NPO, intravenous fluids, and avoid antiperistaltic agents
C. Prescribe oral metronidazole
D. Prescribe oral vancomycin
E. Stop the antibiotic and administer a combination of diphenoxylate and atropine