Spectrum: Local Antimicrobial Stewardship, for Billings Clinic

First Recurrence

First Line Recommended Treatment

Vancomycin
125 mg PO 4 times daily x 10 days

*If metronidazole was used initially

OR

Fidaxomicin
200 mg PO twice daily x 10 days

*If vancomycin was used initially

OR

Prolonged tapered and pulsed vancomycin regimen

*If either vancomycin or fidaxomicin were used originally

Tapered and Pulsed Vancomycin

Vancomycin
125 mg PO 4 times daily x 10-14 days

THEN

Vancomycin
2 times daily x 7 days

THEN

Vancomycin
Once daily x 7 days

THEN

Vancomycin
Every 2 or 3 days for 2-8 weeks