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For patients with a history of Clostridium difficile infection, we would consult with the patient’s primary care practitioner prior to prescribing any antibiotic. Q“What pain regimen do you employ when patients have significant post-herpetic neuralgia? AFrom a lecture we attended on opioid medicines, we learned from an esteemed pain management expert that alternating ibuprofen 400mg QID with 500mg of acetaminophen QID is slightly more effective than the standard 5mg hydrocodone/acetaminophen drugs, so we have heeded this instruction. However, most of the time we direct these patients to a neurologist or a pain management clinic. 1. Goldenberg JZ, Mertz D, Johnston BC. Probiotics to prevent Clostridium Difficile infection in patients receiving antibiotics. JAMA. 2018;320(5):499

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