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.