12
Treatment
Table 3. Recommendations for the Treatment of C. difficile
Infection (CDI) in Adults
Clinical
Definition
Supportive
Clinical Data Recommended Treatment
a
Strength-
Quality
Initial episode,
non-severe
Leukocytosis with
a white blood cell
count of <15,000
cells/mL and a
serum creatinine
level <1.5 mg/dL
Vancomycin 125 mg given qid
for 10 days, OR
S-H
Fidaxomicin 200 mg given
bid for 10 days
S-H
Alternate if above agents are
unavailable: Metronidazole,
500 mg tid PO for 10 days
W-H
Initial episode,
severe
b
Leukocytosis with
a white blood cell
count of ≥15,000
cells/mL or a
serum creatinine
level >1.5 mg/dL
Vancomycin, 125 mg qid PO
for 10 days, OR
S-H
Fidaxomicin 200 mg given
bid for 10 days
S-H
Initial episode,
fulminant
Hypotension
or shock, ileus,
megacolon
Vancomycin, 500 mg qid PO
or by nasogastric tube. If
ileus, consider adding rectal
instillation of vancomycin.
Intravenously administered
metronidazole (500 mg q8h)
should be administered
together with oral or rectal
vancomycin particularly if
ileus is present.
S-M
(oral vanco)
W-L
(rectal vanco)
S-M
(intravenous
metro)
