A 40-year old woman presented to the surgical OPD with features suggestive of colitis. She was on prolonged treatment with clindamycin. Fecal sample was positive for toxin produced by this agent. Her condition improved on treatment with metronidazole. The clinical condition is associated with -

The patient was on clindamycin since long and that have altered the normal Intestinal flora, the predispose the site for Infection by toxigenic clostridium difficult. Management *The precipitating antibiotic should be stopped *first line antimicrobial therapy involves metronidazole (500mg orally 3times daily for 10days) or vancomycin(125mg orally 4times daily for 7-10days). Reference : Davidson, 23rd Edition, page no : 264.