Rosh Emergency Medicine Practice Test

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Prepare for the Rosh Emergency Medicine Test with targeted quizzes and insightful explanations. Boost your medical knowledge and clinically relevant skills to excel in your exam!

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What is the first-line medication for managing a Clostridioides difficile infection?

Bidaxomicin IV for 10 days
Metronidazole PO for 10 days
Vancomycin IV for 10 days
Vancomycin PO for 10 days

The correct answer is: Vancomycin PO for 10 days

The first-line medication for managing a Clostridioides difficile infection is oral Vancomycin. This choice is supported by current clinical guidelines, which recommend it due to its efficacy in targeting the C. difficile bacteria specifically in the gastrointestinal tract. Oral administration allows Vancomycin to remain concentrated in the intestine, where the infection occurs, making it particularly effective for treating the symptoms and the underlying cause of the infection. The use of oral Vancomycin is favored over other options because it reduces the risk of more severe complications associated with C. difficile infections, such as recurrent infections or severe colitis. While metronidazole was historically used as a first-line treatment for mild cases, it is no longer recommended as the primary approach due to concerns about resistance and lower efficacy compared to oral Vancomycin. Inappropriate routes of administration also factor into treatment decision-making. For example, intravenous Vancomycin does not achieve adequate intestinal concentrations to effectively treat C. difficile infections. Therefore, the oral route using Vancomycin is the most effective and reliable method currently recommended for managing these infections.