This is more of a critical care (or general care, if you will) than true pulmonary.
I have been seen a lot of docs (including some ID) treating uncomplicated C. diff colitis with PO vanco up front instead of Flagyl. Have recommendations changed? Do you use much PO vanco?
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I'm using Flagyl, and only adding oral Vanc for severe cases.
we use flagyl as first line. More recently there has been increase in resistant strains that respond to PO vanco, but since we don't test for this a priori, we start with flagyl and change if not responding.
Incidentally, I think the increase in flagyl-resitant strain at our hospital is related to (lack of) handwashing....
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