C difficile Infection (Antibiotic Associated Colitis)

Antimicrobial prescribing: NHS Forth Valley
NHS Forth Valley

Micro Organisms

C difficile

Severe or Recurrence - (First line)

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

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

Stop any antimotility agents, laxatives and gastric acid suppressants (e.g. PPI's) if possible

Rehydrate patient

Assess symptoms and severity of disease on a daily basis

Vancomycin vials for injection can be opened and given orally or via enteral tubes - speak to pharmacy for advice if requiredÂ