Spectrum: Local Antimicrobial Stewardship, for IWK Health Centre

Severe, complicated

First Line

Vancomycin 125-500 mg PO QID for 10-14 days or via nasogastric tube

AND

Metronidazole 500 mg IV Q 8 H

Severe Allergy To Oral Vancomycin

Fidaxomicin 200 mg PO BID for 10 days (non-formulary)

AND

Metronidazole 500 mg IV Q 8 H

Paralytic Ileus Is Present

Consider administering Vancomycin

rectally 500 mg in approximately 100 mL normal saline per rectum every 6 hours as a retention enema

PLUS

Metronidazole 500 mg IV Q 8 H

AND

Oral Vancomycin