Table 1. Potential Treatment Agents for Treatment of the
Primary Episode
Agent Adult Dose Cost
a
Initial
Treatment
Response Recurrence Risk
b
Proven Efficacy
Vancomycin 125 mg PO qid
× 10 days
$$$$
$ (Liq)
+++ ++
Fidaxomicin 200 mg PO bid
× 10 days
$$$$ +++ +
Metronidazole 500 mg PO tid
× 10 days
$ ++ ++
Probable Efficacy
Nitazoxanide 500 mg PO bid
× 10 days
$$ +++ ++
Fusidic acid 250 mg PO tid
× 10 days
N/A in USA ++ ++
Inadequate Data To Support Efficacy
Rifaximin 400 mg PO tid
× 10 days
$$$ ++ +?
Tigecycline 50 mg IV every
bid × 10 days
$$$$ ++? ?
Bacitracin 25,000 units PO
qid × 10 days
$$ + +?
a
All prices are estimated in US dollars as quoted from Red Book Online Search, Micromedex Solutions,
last accessed on March 10, 2015 or approximated hospital pharmacy pricing (tigecycline, bacitracin).
b
+, lowest; ++, intermediate; +++, highest; ?, unknown
$: $0–100; $$: $101–500; $$$: $501–1000; $$$$: >$1000
Only use DIFICID for infec on proven or strongly suspected to be caused by C. difficile. Prescribing
DIFICID in the absence of a proven or strongly suspected C. difficile infec on is unlikely to provide
benefit to the pa ent and increases the risk of development of drug-resistant bacteria.
The most common adverse reac ons reported in clinical trials are nausea (11%), vomi ng (7%),
abdominal pain (6%), gastrointes nal hemorrhage (4%), anemia (2%), and neutropenia (2%).
Treatment
