Additional Recommendations

Discontinue concomitant antimicrobial therapy to reduce the risk of CDI.

If the patient must remain on antibiotics, de-escalate/change to an antibiotic that is low-risk for CDI such as:

• Aminoglycosides

• Tetracyclines

• Macrolides

• Sulfonamides (SMX-TMP)

Please contact ASP at (Pager) 352-1461 for assistance.

Discontinue bowel regimens including stool softeners, laxatives and antiperistaltic agents

For example:

• Docusate

• Sennosides

• Loperamide

• Metoclopramide

• Polyethylene glycol

Physician must address acid-suppressing agents such as proton-pump inhibitors (PPIs) (e.g. esomeprazole) or H2-receptor antagonists (H2s) (e.g. ranitidine, famotidine)

Options

• Discontinue ALL acid-suppressing agents

• Discontinue PPI and initiate alternative therapy (e.g. ranitidine, sucralfate)

• Continue PPI. Physician to document indication (e.g. active GI bleed)