Final answer:
The next step for an elderly patient with a C. difficile infection is to stop the antibiotics that may have caused the infection and start supportive care, including fluid and electrolyte replacement. If antibiotics are needed, vancomycin or metronidazole are often used, and fecal transplantation may be an option for recurrent cases.
Step-by-step explanation:
For an elderly patient developing a Clostridium difficile (C. difficile) infection, the next step is to discontinue the use of the offending antibiotics and begin supportive care. This includes electrolyte replacement, fluid replenishment, and potential use of specific antibiotics such as metronidazole or vancomycin. The latter is preferred when metronidazole is not effective or the patient meets certain criteria.
In the provided case scenario, after returning home from a hospital stay involving antibiotic use, an elderly patient, Javier, developed symptoms indicative of a C. difficile infection. Upon hospitalization, tests revealed elevated kidney creatinine levels, and a stool sample was tested using a nucleic acid amplification test (NAAT) to confirm the presence of the C. difficile toxin B gene (tcdB). Ultimately, the patient was diagnosed with a C. difficile infection and treated with vancomycin, leading to recovery.