What is the diagnosis for Diffraction (no clear medical term), assuming you meant 'Differential' (Diff), what is the differential diagnosis?

From the Guidelines

The diagnosis of microscopic colitis should be based on a combination of clinical history, endoscopic appearance, and distinct histologic patterns, with collagenous colitis and lymphocytic colitis being the two major entities 1. When diagnosing microscopic colitis, it is essential to consider the clinical history of chronic watery diarrhea, a normal or almost normal endoscopic appearance of the colon, and a distinct histologic pattern 1. The histologic pattern can be either collagenous colitis, characterized by a thick amorphous hyaline eosinophilic band immediately beneath the surface epithelium of the mucosa, or lymphocytic colitis, which is characterized by an increased number of lymphocytes in the epithelium 1. Some key points to consider when diagnosing microscopic colitis include:

• The absence of pseudomembranes in C. difficile-associated diarrhea in patients using immunosuppressive agents 1
• The endoscopic finding of pseudomembranes is reported in 50% of C. difficile infected patients, and is less common (13%) in IBD patients with C. difficile 1
• The typical histologic findings of pseudomembranous colitis are usually not present in microscopic colitis 1
• The use of immunohistochemistry (IHC) and quantitative tissue PCR can improve the diagnosis of CMV infection in active IBD 1. It is crucial to note that the pathogenesis of microscopic colitis is still not completely understood and probably multifactorial, representing a specific mucosal response, in susceptible individuals to various noxious luminal agents 1. In real-life clinical practice, a thorough diagnostic workup, including endoscopy and histology, is necessary to establish an accurate diagnosis of microscopic colitis 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Comparison of Vancomycin and Metronidazole for Clostridium difficile Infection

• The effectiveness of vancomycin and metronidazole for the treatment of Clostridium difficile infection has been compared in several studies 2, 3, 4, 5, 6.
• A study published in JAMA internal medicine found that vancomycin was superior to metronidazole in reducing the risk of 30-day mortality among patients with severe CDI 2.
• A meta-analysis published in The Brazilian journal of infectious diseases found that vancomycin provided improved initial clinical and sustained cure rates in patients with CDI compared with metronidazole, especially in patients with severe CDI 4.
• Another meta-analysis published in the Journal of infection and chemotherapy found that vancomycin had superior clinical effects compared with metronidazole in severe CDI cases 5.
• A review published in The Annals of pharmacotherapy found that the available outcome data suggested that vancomycin was more effective than metronidazole for the treatment of mild-to-moderate CDI, and that vancomycin should be considered the preferred agent for this indication 6.

Efficacy of Vancomycin and Metronidazole

• The efficacy of vancomycin and metronidazole for the treatment of CDI has been found to be similar in some studies, especially for mild-to-moderate cases 3, 5.
• However, vancomycin has been found to have superior efficacy compared with metronidazole in severe CDI cases 2, 4, 5.
• The recurrence rates of CDI have been found to be similar between vancomycin and metronidazole in some studies 4, 5.

Safety and Tolerability

• The safety and tolerability profiles of vancomycin and metronidazole have been found to be similar in some studies 5, 6.
• However, vancomycin has been found to have a more favorable pharmacokinetics profile compared with metronidazole 6.