Table 1.

Guidelines for Treatment of Mild, Severe, and Complicated Clostridium difficile–associated Disease (CDAD)

	Criteria	Treatment
Mild–moderate CDAD		Metronidazole 500 mg TID × 10–14 days
Severe CDAD	WBC >15,000 cells/μL or >50% rise in serum creatinine	Vancomycin 125 mg PO QID × 10–14 days
Complicated CDAD	Hypotension, ileus, toxic megacolon, need for intensive care unit admission or colectomy, colonic perforation, lack of response to therapy	Vancomycin 500 mg QID orally (if able to tolerate oral medication) or per nasogastric tube and/or metronidazole 500–750 mg IV every 8 hrs If complete ileus, IV metronidazole as above plus vancomycin enemas (500 mg 100 mL normal saline every 6 hr via rectal foley) Early surgical consultation Early colectomy before lactate ≥5 mmol/L

Adapted from Cohen SH¹⁶ with permission.

IV

intravenous

WBC

white blood cell count