Clostridium Difficile

Clostridium difficile

DH

PHE

Stop unnecessary antibiotics and/or PPIs.

70% respond to metronidazole (MTZ) in 5 days; 92% in 14 days. 

If severe symptoms or signs (below) should treat with oral vancomycin, review progress closely and/or consider hospital referral.

Definition of severe: T >38.5oC, or WCC >15, or rising creatinine or signs/symptoms of severe colitis.

1st episode:

metronidazole (MTZ)

 

 400mg or 500mg TDS

10-14 days

 

2nd episode/severe/type 027:

oral vancomycin

 

 125mg QDS

 

10-14 days

Recurrent disease see rationale: oral vancomycin

125mg QDS, consider taper

10-14 days

or fidaxomicin

200mg BD

10 days