Recommendations

For mild-moderate C. difficile diarrhea (<1 point), treat with metronidazole (Flagyl) PO 500 mg tid.

For severe disease (>2 points), use vancomycin 125 mg PO qid. For patients who cannot receive oral medications, IV metronidazole 500 mg qid and vancomycin by nasogastric tube ± rectal enema should be administered.

ICU, Intensive care unit; CT, computed tomography; PO, by mouth; IV, intravenous; qid, four times daily; tid, three times daily; WBCs, white blood cells.

Modified from Zar FA, Bakkanagari FR, KMLST, et al. A comparison of vancomycin and metronidazole for the treatment of Clostridium difficile-associated diarrhea, stratified by disease severity. Clin Infect Dis 2007;45:302-307.

The complete reference list is available online at www.expertconsult.com.

Standards, Practice Guidelines, and Statements Developed and/or Endorsed by Infectious Diseases Society of America. Systematically developed statements to assist practitioners and patients in making decisions about appropriate health care for specific clinical circumstances. www.cdc.gov/std/

Up-to-date information on sexually transmitted diseases (STDs) and their treatment. www.cdc.gov/tb/

Up-to-date information on tuberculosis and its treatment. www.cdc.gov/ticks/-

Up-to-date information on tick-borne diseases and their treatment. www.tripprep.com/scripts/main/default.asp

Information for travelers by destination and illness and an extensive listing of Travel Medicine providers throughout the world; requires free registration.

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