Spectrum: Local Antimicrobial Stewardship, for Markham Stouffville Hospital

First Episode, Critical Illness

Treatment Options

ORAL Vancomycin 10 mg/kg po QID

  • Max 125 mg/dose

  • Higher doses are used in some cases (example up to 2000 mg/day) – consult Infectious Disease.

PLUS

INTRAVENOUS Metronidazole 10 mg/kg IV TID
  • Max 500 mg/dose

Duration

10 Days

If Complete Ileus

Consult Gastroenterology and ID services to review

May consider addition of rectal vancomycin

Rectal Vancomycin

Vancomycin 10 mg/kg per dose in 0.9% Sodium Chloride (maximum dose: 500 mg in 100 mL normal saline) administered by retention enema four times per day

The volume of solution varies with age:

  • 1 - 4 years old: 50 mL

  • 5 - 11 years old: 75 mL

  • Greater than or equal to 12 years old: 100 mL