Clostridioides difficile infection (CDI) is defined by the presence of:
* Patients with severe disease may not have loose stools if they have toxic megacolon or ileus.
Last reviewed May 2019
Last reviewed May 2019
*Exception - cases where ileus may be possible (e.g. severe and complicated disease)
Last reviewed May 2019
RECURRENT EPISODES
Category | Severity criteria | Treatment recommendation |
---|---|---|
First recurrence, mild to moderate |
|
|
|
|
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Second or subsequent recurrence |
Vancomycin Taper
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Last reviewed May 2019
1. Loo VG, Davis I, Embil J, Evans GA, et al. Association of Medical Microbiology and Infectious Disease Canada treatment practice guidelines for Clostridium difficile infection. Journal of the Association of Medical Microbiology and Infectious Disease Canada. 2018; 3(2): 71-92.
2. McDonald LC, Gerding DN, Johnson S, Bakken JS, et al. Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis. 2018; 66(7):e1-e48.
3. Van Hise NW, Bryant AM, Hennessey EK, Crannage AJ, et al. Efficacy of Oral Vancomycin in Preventing Recurrent Clostridium difficile Infection in Patients Treated With Systemic Antimicrobial Agents. Clin Infect Dis. 2016 Sep 1;63(5):651-3.
4. Appaneal HJ, Caffrey AR, LaPlante KL. What is the role for metronidazole in the treatment of Clostridium difficile infection? Results from a national cohort study of Veterans with initial mild disease. Clin Infect Dis. 2018; Dec 18 [Epub ahead of print].
5. Fabre V, Dzintars K, Avdic E, Cosgrove SE. Role of Metronidazole in Mild Clostridium difficile Infections. Clin Infect Dis. 2018;67(12):1956-1958.
Last reviewed May 2019
Last reviewed July 2020
Last reviewed July 2020
Last reviewed July 2020
Antibiotic recommendations in table below are empiric, should tailor antibiotics to microbiology results.
Last reviewed June 2023
Last reviewed July 2020
1. Mazuski JE, Tessier JM, May AK, et al. The Surgical Infection Society Revised Guidelines on the Management of Intra-Abdominal Infection. Surg Infect (Larchmt). 2017 Jan;18(1):1-76.
2. Sawyer RG, Claridge JA, Nathens AB, et al. Trial of short-course antimicrobial therapy for intraabdominal infection. N Engl J Med. 2015 May 21;372(21):1996-2005.
3. Solomkin JS, Mazuski JE, Bradley JS, et al. Diagnosis and Management of Complicated Intra-abdominal Infection in Adults and Children: Guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Clin Infect Dis 2010; 50: 133-64.