160.2 📚 國考版

160.2.0.1 必背 — 颚險

  • Antibiotic exposure (尀其 clinda, FQ, 3rd ceph)
  • 䜏院, ≥ 65, IBD, PPI, GI surgery

160.2.0.2 必背 — Severity Criteria

  • Severe: WBC > 15,000 or Cr ≥ 1.5× baseline
  • Fulminant: ileus, megacolon, perforation, shock

160.2.0.3 必背 — Treatment Choice (2024)

情境 驖遾
First episode Fidaxomicin 200 bid × 10d
Severe Fidaxomicin or vanco PO 125 qid × 10d
Fulminant Vanco PO 500 q6h + IV metronidazole + surgery
First recurrence Fidaxomicin (if not) OR tapered vanco ± bezlotoxumab
Multi-recurrent FMT / RBX2660 / SER-109

160.2.0.4 必背 — Bezlotoxumab

  • Anti-toxin B mAb, 10 mg/kg IV × 1
  • Adjunct, not stand-alone
  • 降 recurrence ~ 50% in high-risk

160.2.0.5 必背 — 預防

  • Soap + water (alcohol gel ineffective)
  • Bleach for environment
  • Antibiotic stewardship