Stop unnecessary antibiotics, gastric acid suppressants, laxatives and anti-motility agents.
70% respond to metronidazole 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 (>1.5 x baseline) or signs/symptoms of severe colitis.
1st episode with NO severity markers:
If no response after 5 days switch to oral vancomycin
400mg three times daily
1st episode with ≥1 severity markers or no response to metronidazole after 5 days (refer to hospital):
125mg four times daily