Professional and Linguistic Assessments Board (PLAB) Practice Exam

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Which drugs are commonly associated with causing C. Diff infection?

Clindamycin and 2nd Cephalosporins
Amoxicillin and Macrolides
Fluoroquinolones and Tetracyclines
Penicillin and Carbapenems

The correct answer is: Clindamycin and 2nd Cephalosporins

Clindamycin and second-generation cephalosporins are well-known for their strong association with Clostridium difficile (C. diff) infections. The mechanism behind this association lies in how these antibiotics disrupt the normal gut flora. Clindamycin, in particular, is effective against anaerobic bacteria, but it can also eliminate beneficial bacteria that typically keep C. diff in check. This disruption allows C. diff to overgrow, as it is resistant to many antibiotics. Second-generation cephalosporins also carry a risk for C. diff infections. While they are broader-spectrum antibiotics, their use can similarly disturb the balance of the gut microbiome, promoting an environment in which C. diff can proliferate. The other options present alternatives that are less commonly linked to C. diff complications. In summary, the correct association of C. diff infection with Clindamycin and second-generation cephalosporins highlights the critical understanding of antibiotic stewardship and the importance of preserving the gut microbiome to prevent such infections.