C difficile Infection (Antibiotic Associated Colitis)

Micro Organisms

C difficile

Mild / Non - Severe

Important: Therapy

Metronidazole PO for 10 days

or

Vancomycin PO for 10 days

Notes:

Maintain accurate stool chart

Severe

Important: Therapy

Vancomycin PO for 10 days

Add IV metronidazole if ileus or hypotension

CONSIDER URGENT SURGICAL REVIEW

Notes:

Maintain accurate stool chart

Consider systemic antibiotics (Vancomycin IV + gentamicin IV + metronidazole IV) if severe colonic inflammation in addition to above therapy

Important: Notes

Observe bowel movements, symptoms, (WCC and hypotension) and fluid balance. If symptoms continue to worsen, refer to gastroenterology / surgery, and discuss with microbiology.

Ensure infection control measures are in place including stool chart - do no wait for confirmation of diagnosis

Send stool sample

Stop and (non-Clostridium difficile) antimicrobial treatment in patients with CDI if possible

Stop any antimotility agents, laxatives and gastric acid suppressants if possible

Rehydrate patient

Assess symptoms and severity of disease on a daily basis