How is C difficile infection treated
- The first treatment for C. difficile infection is to stop any offending antibiotics, if possible. If symptoms persist, treatment depends on the clinical context.
- For mild to moderate infections, oral metronidazole (500 mg tid for 10-14 days) remains the agent of choice. In severe infection (two or more points based on the following: one point each for temperature > 38.3° C, age > 60 years, albumin < 0.025 g/L, white blood cell count > 15 × 10 9 cells/L; two points for pseudomembranous colitis or intensive care unit) oral vancomycin (125 mg qid × 10-14 days) is warranted as it is approximately 20% more effective in this setting.
- For complicated severe infection, intravenous (IV) metronidazole (500 mg q8h) may be added.
- Higher-dose vancomycin, alternative antibiotics (rifaximin), and fecal microbiota transplantation may be considered for relapsing or recurrent disease.
