Clostridium Difficile

Main Content

Severe Infection, Not Complicated or Fulminant

Indications

  • C. diff positive diarrhea and any of the following:
    • WBC>15,000
    • Serum creatinine ≥1.5x baseline
    • Acute decrease in albumin to <3.0 g/dl

First line treatment*

  • Vancomycin 125mg PO every 6 hours
  • Consider adding Vancomycin 500mg/100mL enema every 6 hours for those with ileus.**

Duration

  • 10 days

Notes

For all patients: Discontinue acid suppressants, pro-kinetics, and concomitant antibiotics if possible.

*Metronidazole is no longer first line and is now only recommended for patients without access to Vancomycin or Fidaxomicin and only in mild caseses and as adjuct in fulminant colitis particularly in the setting of ileus.

**Suspend 500mg in 100mL 0.9% saline. Instill via rectal foley catheter and retain 1 hour.

Disclaimer: The contents of this application are for the exclusive and specific use of University of Mississippi Medical Center faculty and trainees. Any other use is neither authorized nor sanctioned by UMMC. The information is for educational purposes only. The contents of this application are for the exclusive and specific use of UMMC faculty and trainees. Any other use is neither authorized nor sanctioned by UMMC. The information is for educational purposes only.