Table 2.
ATLAS score | ATLAS classification | First episode | First recurrence | ≥ 2 recurrences |
---|---|---|---|---|
0 | Mild CDAD | Metronidazole 500 mg PO/IV q8h | Vancomycin 125–250 mg PO q6h | Fidaxomicin 200 mg PO BID or Vancomycin taperb |
1 | ||||
2 | ||||
3 | Moderate CDAD | Vancomycin 125–250 mg PO q6h | Fidaxomicin 200 mg PO BID | Fidaxomicin 200 mg PO BID or Vancomycin taperb |
4 | ||||
5 | Severe CDAD | Fidaxomicin 200 mg PO BID | Fidaxomicin 200 mg PO BID | Fidaxomicin 200 mg PO BID or Vancomycin taperb |
6 | ||||
7 | ||||
8 | ||||
9 | ||||
10 | ||||
Any | Fulminant CDADa | Fidaxomicin 200 mg PO BID + Metronidazole 500 mg IV q8h | Fidaxomicin 200 mg PO BID + Metronidazole 500 mg IV q8h | (Fidaxomicin 200 mg PO BID or Vancomycin taperb) + Metronidazole 500 mg IV q8h |
aCDAD in presence of hypotension/shock (SBP < 90 mmHg requiring vasopressor therapy), ileus, or toxic megacolon
bVancomycin taper: vancomycin 125 mg PO q6h × 10 days, followed by vancomycin 125 mg PO q12h × 7 days, followed by vancomycin 125 mg PO q24h × 7 days, then vancomycin 125 mg PO every 3 days × 14 days