What is the first-line antibiotic treatment indicated for mild Clostridium difficile colitis?

For mild Clostridium difficile colitis, the first-line antibiotic treatment is metronidazole. This drug is specifically indicated because it effectively targets the anaerobic environment of the colon, which is where C. difficile proliferates and causes colitis. Metronidazole is chosen due to its efficacy and favorable response in cases categorized as mild, where symptoms typically include mild diarrhea and abdominal cramps.

The dosing regimen of metronidazole—500 mg taken orally three times a day for 10 days—is aligned with clinical guidelines for treating mild C. difficile infections, helping to both clear the infection and minimize the risk of recurrence.

Other antibiotics listed, such as ciprofloxacin, levofloxacin, and trimethoprim-sulfamethoxazole, are not first-line treatments for C. difficile colitis. Those options may not provide effective coverage for the specific strain of C. difficile and may also disrupt normal gut flora, potentially worsening the condition. Consequently, metronidazole stands out as the most appropriate and clinically recommended choice for managing this infection in its mild form.