Pseudomembranous colitis (PMC)/Clostridium Difficile Infection

PMC is caused by Clostridium difficile which is a spore producing gram positive rod/bacillus. It's incidence is about 0.5% in hospitalized adults. PMC typically occurs in setting of altered gut flora due to antibiotics.

Common antibiotics impicated include: Clindamycin, Ciprofloxacin (and other fluoroquinolones), Cephalosporins and macrolides. Both Vancomycin and Metronidazole which are used in treatment of PMC can also cause PMC. Omeprazole(and other proton pump inhibitors) and chemotherapeutic drugs have also been shown to increase risk for PMC.

Treatment is typically done with oral metronidazole (Flagyl) or oral vancomycin. Of the two metronidazole is usually preferred because it is relatively inexpensive and to reduce the risk of developing vancomycin resistant enterococci (VRE) organisms.