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. 2018 Oct 11;17:37. doi: 10.1186/s12941-018-0288-3

Table 2.

Clostridium-difficile associated diarrhea treatment pathway using ATLAS scoring (Florida)

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