Final answer:
Metronidazole, vancomycin, fidaxomicin, and clindamycin are the four most common antibiotics associated with C. difficile colitis.
Step-by-step explanation:
The four most common antibiotics associated with C. difficile colitis are metronidazole, vancomycin, fidaxomicin, and clindamycin.
Metronidazole is the preferred treatment for C. difficile colitis and is effective in most cases. It works by inhibiting the growth of C. difficile and reducing the production of toxins. Vancomycin is another antibiotic that can be used to treat C. difficile colitis, but it is usually reserved for cases where metronidazole has been ineffective or for patients who meet specific criteria, such as being pregnant or allergic to metronidazole.
Fidaxomicin is a newer antibiotic that has been approved for the treatment of C. difficile colitis. It works by inhibiting the growth of C. difficile while preserving the normal gut microbiota. Clindamycin is an antibiotic that is not recommended for the treatment of C. difficile colitis because it can actually increase the risk of developing the infection.
When a patient develops C. difficile colitis, the first step is to discontinue the inciting antibiotic and provide supportive therapy. If the patient has a confirmed diagnosis of C. difficile, metronidazole is the preferred initial treatment, with vancomycin reserved for certain situations such as metronidazole failure or if the patient meets specific criteria such as being under 10 years old, pregnant, or allergic to metronidazole. Additionally, fecal transplants have shown to be over 90% effective in resolving C. difficile infections by restoring the normal gut flora.