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. 2014 Oct 6;30(5):304–309. doi: 10.1159/000366302

Table 3.

Summary of treatment recommendations according to disease severity (adapted from [9])

Severity Criteria Treatment Comment
Mild-to-moderate disease diarrhoea, no signs or symptoms of severe disease metronidazole 500 mg p.o. 3×/day for 10 days if no improvement in 5–7 days switch to vancomycin 4 × 125 mg p.o.
Severe disease

  • two of the following:

  • albumin < 30 g/l;

  • leukocytosis >15 Gpt/l;

  • creatinine >133 μmol/l;

  • age > 65 years;

  • abdominal tenderness;

  • comorbidities

 vancomycin 125 mg p.o. 4×/day for 10 days other authors consider age < 65 years and a rise in creatinine >1.5 × baseline as equal risk factors for severe disease
Severe and complicated disease

  • any of the following attributable to CDI:

  • admission to ICU for CDI;

  • prolonged hypotension;

  • ileus or significant abdominal distension;

  • mental status changes;

  • leukocytes > 35 Gpt/l or < 2 Gpt/l

 vancomycin 500 mg p.o. 4×/day and metronidazole 500 mg i.v. 3×/day and vancomycin per rectum (500 mg vancomycin in 500 ml Nalco 0.9%) 2–4×/day consider surgical consultation