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Antimicrobials
Contact Precautions
Institute contact precautions plus for any suspected or confirmed CDI case
10 days - see below for taper
Consider Infectious Diseases consultation
If initial CDI episode treated with metroNIDAZOLE:
Vancomycin 125 mg PO/NG QID for 10 days
OTHERWISE
If second or subsequent recurrence or previously treated with standard vancomycin regimen of 10 to 14 days:
Complete Vancomycin 125 mg PO/NG QID for 10 to 14 days, then vancomycin taper and pulse: -vancomycin 125 mg BID for 7 days, then -vancomycin 125 mg daily for 7 days, then -vancomycin 125 mg every 2 days for 8 days, then -vancomycin 125 mg every 3 days for 15 days
Probiotics (i.e. Lactobacillus) or cholestyramine are NOT recommended as adjunctive treatment for or prevention of recurrent CDI as evidence regarding their efficacy is unclear.
Infectious Diseases consultation should be considered for patients who have other infections requiring concomitant antibiotics in setting of C. difficile infection
