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[chattie]

A physician wants to initiate antimicrobial therapy to treat hospitalized patient

C difficile

-associated diarrhea. the physician wants to prescribe intravenous (IV) antibiotics. He orders IV vancomycin. Physician want you review order. Should the pharmacist make any recommendations on antibiotic therapy? Is oral vancomycin is good enough to recommend?

[Expert Tips]

If patient has no contraindications to oral therapy. Metronidazole is the drug of choice for Clostridium difficile. Although oral vancomycin is effective, the risk of vancomycin-resistant enterococci makes it a less desirable option. As for intravenous (IV) therapy, IV vancomycin is considered less effective than IV metronidazole. IV vancomycin does not achieve sufficient drug concentrations in the intestinal lumen.

Reference: Lauren S. Schlesselman, PhramD. assistant clinical professor at the University of Connecticut School of Pharmacy.