Which of the following antibiotics should be avoided in patients with a history of C. difficile infection?

Clindamycin is often associated with a higher risk of Clostridium difficile infection (CDI). This antibiotic disrupts the normal gut flora, which can allow for the overgrowth of C. difficile and lead to gastrointestinal complications, including severe colitis. Patients with a history of CDI are particularly vulnerable to recurrence, and clindamycin’s mechanism of action makes it a less favorable choice in such cases. Therefore, avoiding clindamycin in patients with a past C. difficile infection is appropriate to mitigate the risk of recurrence and ensure safer management of their infections.

While vancomycin is actually used to treat CDI, and both azithromycin and moxifloxacin have a lower association with CDI, clindamycin’s potent impact on gut flora makes it the antibiotic that should be avoided in this specific scenario.