Among all antibiotics in current use, the one most strongly associated with subsequent Clostridioides difficile colitis, and therefore least appropriate when equally effective alternatives exist, is:
- A Azithromycin
- B Clindamycin ✓
- C Ceftriaxone
- D Nitrofurantoin
Correct answer: B. Clindamycin
Explanation
Clindamycin has the highest relative risk of C. difficile infection of any antibiotic class because its potent suppression of anaerobic gut flora allows overgrowth of the organism. Broad-spectrum cephalosporins and fluoroquinolones are also important culprits but rank below clindamycin. Nitrofurantoin, confined to the urinary tract, carries negligible risk. Indian exam convention consistently lists clindamycin as the classic answer for this association.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.