After a C. Diff. Infection

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78 year old male living in a long term care facility was recently treated with a couple of different courses of antibiotics to treat recurrent respiratory infections.  Treatment was eventually successful, but a few days following the final treatment with antibiotics, diarrhea started to develop.  It started out fairly mild but was progressing to several loose stools per day.  The physician was notified of the diarrhea and nurses had wondered if Imodium would help resolve the issues.  Imodium 2 mg twice daily was prescribed, with additional doses after each loose stool (up to a max of 16 mg/day).  Even with Imodium, the loose stools did not completely resolve.  C. Diff. testing was performed and it was indeed positive.  The resident was treated with metronidazole which was successful.  Diarrhea was 100% resolved and the resident was without any lingering symptoms.  In the effort and justified concern with treating the C. Diff infection, what was forgotten about was that the resident was still on the Imodium months after the C. Diff. has been treated.  The lesson here is to remember avoid long term medication use for an obvious short term problem that resolved with treatment.

1 Comment

  1. Leo Lawless

    Based on the age of the patient, 78, and the history of antibiotic treatment C. Diff. should have been suspected and ruled out prior to the use of imodium. The mean age for hospitalized or nursing home patients developing C. Diff is 75.
    This also points out the importance of having a pharmacist doing a medication history routinely on such patients and avoiding the continuance of medication not indicated.


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Written By Eric Christianson

July 30, 2014

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