This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Bacterial infection, Subject name: Medicine
All are useful for management of severe clostridium difficile treatment except: 
Select and explain. 
A. Intravenous Metronidazole, B. Neomycin enema, C. Fecal transplant, D. Tigecycline
B: Neomycin enema
Answer: B: Neomycin enema 
Explanation: Treatment of CDI: Initial episode Oral vancomycin orFidaxomicin Fulminant CDI Vancomycin plusmetronidazole IV plus considerRectal instillation of vancomycin Consider using IV tigecycline in place of metronidazole Multiple recurrences Vancomycin; orFidaxomicin orFecal microbiota transplantation (FMT)