Table 2.

Summary of current recommendations for treatment of RCDI

	Treatment Guidelines*
	ESCMID102	IDSA-SHEA28	ACG103
FIRST RECURRENCE
	Fidaxomicin or vancomycin recommended over metronidazole.	Repeat treatment as in initial episode. Vancomycin recommended in severe# cases.	Repeat treatment as in initial episode. Vancomycin recommended in severe& cases.
	Fidaxomicin orally 200 mg twice daily for 10 days	Metronidazole orally 500 mg three times daily for 10–14 days	Metronidazole orally 500 mg three times daily for 10 days
	Vancomycin orally 125 mg four times daily for 10 days	Vancomycin orally 125 mg four times daily for 10–14 days	Vancomycin orally 125 mg four times daily for 10 days
	Metronidazole orally 500 mg three times daily for 10 days
SECOND RECURRENCE
	Pulsed/tapered vancomycin or fidaxomicin.	Vancomycin in a tapered and/or pulsed regimen.	Pulsed vancomycin regimen.
	Vancomycin orally 125 mg four times daily for 10 days followed by pulse strategy (125–500 mg/day every 2–3 days for at least 3 weeks)	Vancomycin orally 125 mg four times daily for 10–14 days, 125 mg twice daily for a week, 125 mg once daily for a week, and then 125 mg every 2 or 3 days for 2–8 weeks	Vancomycin orally 125 mg four times daily for 10 days followed by 125 mg daily pulsed every 3 days for ten doses
	Vancomycin orally 125 mg four times daily for 10 days followed by taper strategy (gradually decreasing the dose to 125 mg per day)
	Fidaxomicin orally 200 mg twice daily for 10 days
SUBSEQUENT RECURRENCE NONRESPONSIVE TO ANTIBIOTIC THERAPY
	FMT in combination with oral antibiotic treatment is strongly recommended.	No recommendation.	Fecal microbiota transplant (FMT) should be considered.
	No specific regimen recommended		No specific regimen recommended

^*Guidelines are summarized and accompanied by recommended treatment regimens

^#Severe: white blood cell count (WBC) ≥15,000 cells/mL

^&Severe: serum albumin < 3 g/dl plus WBC ≥ 15,000 cells/mL and/or abdominal tenderness