160.4 📌 章末速蚘

  • C. difficile — antibiotic-disrupted flora, spore-forming
  • Toxin A + B; B 是 main virulence (bezlotoxumab target)
  • Test 只 if symptomatic (NAAT + toxin EIA combo)
  • First-line: Fidaxomicin (2024 IDSA + ACG)
  • Fulminant: PO vanco 500 q6h + IV metro + surgery
  • Recurrence: fidaxomicin → bezlotoxumab adjunct → FMT / RBX2660 / SER-109
  • Soap + water (alcohol gel useless on spores!)
  • 抗生玠 stewardship + isolation + bleach
  • Metronidazole 䞍再 first-line (2017 onwards)
  • Bezlotoxumab 10 mg/kg IV × 1 in high-risk recurrence (caution HF)