The treatment of choice for pseudome-mbranous colitis is (AIIMS Nov 2011)
a. C. difficile is an obligately anaerobic, gram-positive, spore-forming bacillus whose spores are found widely in nature, particularly in the environment of hospitals and chronic-care facilities.
c. Clindamycin, ampicillin, and cephalosporins were the first antibiotics associated with CDAD.
d. The second- and third-generation cephalosporins, particularly cefotaxime, ceftriaxone, cefuroxime, and ceftazidime, are agents frequently responsible for this condition, and the fluoroquinolones (ciprofloxacin, levofloxacin, gatifloxacin, and moxifloxacin) are the most recent drug class to be implicated in hospital outbreaks
e. The pseudomembranes of PMC are confined to the colonic mucosa and initially appear as 1- to 2-mm whitish-yellow plaques.
f. The intervening mucosa appears unremarkable, but, as the disease progresses, the pseudomembranes coalesce to form larger plaques and become confluent over the entire colon wall.
g. Viewed microscopically, the pseudomembranes have a mucosal attachment point and contain necrotic leukocytes, fibrin, mucus, and cellular debris.
h. The epithelium is eroded and necrotic in focal areas, with neutrophil infiltration of the mucosa.
i. General treatment guidelines include hydration and the avoidance of antiperistaltic agents and opiates, which may mask symptoms and possibly worsen disease.