First episode of Clostridioides difficile infection after co-amoxiclav
Write a prescription for clostridioides difficile infection (first episode) and have every line marked: drug choice, dose, route, frequency and duration, checked against the patient's allergies, current medicines, renal function and the interaction database, with each error explained.
medium8 scoring rules
- Patient
- 72 years, female, 65 kg
- Diagnosis
- Clostridioides difficile infection (first episode)
- Allergies
- None known
- Current medicines
- atorvastatin 20 mg once daily; ramipril 5 mg once daily; omeprazole 40 mg once daily; amoxicillin/clavulanate intravenous
The scenario
Patient C-104 is a 72-year-old woman admitted to an acute medical ward for intravenous co-amoxiclav for community-acquired pneumonia. On day 5 of her course, she develops profuse watery diarrhoea, six to eight stools per day, with mild lower abdominal cramping. On examination, temperature 38.2°C, pulse 102 bpm, blood pressure 110/68 mmHg, respiratory rate 18/min, oxygen saturation 96% on room air. Abdomen is soft with lower abdominal tenderness, no guarding. Stool sample is positive for Clostridioides difficile toxin. White cell count is 14.2 × 10⁹/L, C-reactive protein 86 mg/L. She has no known drug allergies. Her regular medicines are atorvastatin 20 mg once daily and ramipril 5 mg once daily. In addition to co-amoxiclav, she is on omeprazole 40 mg once daily for gastro-oesophageal reflux. Weight 65 kg. She is not pregnant. Write the prescription for the C. difficile infection, including any changes to her current antimicrobial therapy.
What gets marked
- Whether you chose an indicated drug, and whether you avoided the contraindicated ones.
- Dose, route, frequency and duration against the range for this patient.
- Renal and hepatic dose adjustment where this patient's numbers demand it.
- Allergy cross-reactivity and interactions with the medicines already on the chart.
- The instructions and monitoring you write, not only the drug you pick.
8 scoring rules apply to this scenario. A single critical error fails the attempt whatever the score.
Log in to prescribe for "First episode of Clostridioides difficile infection after co-amoxiclav"
A free account opens the prescription pad: search the formulary, write the chart, and have it marked line by line by the safety engine.
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Educational content for students and clinicians in training. It does not replace professional judgement, local protocols or current prescribing information.