How are fulminant cases of Clostridium difficile (C diff) colitis treated?

Updated: Jul 25, 2019
  • Author: Faten N Aberra, MD, MSCE; Chief Editor: BS Anand, MD  more...
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In fulminant cases, combined therapy with intravenous metronidazole and vancomycin (PO or PR) is the treatment of choice. [5] Intravenous vancomycin is ineffective and should not be used for C difficile. The SHEA and IDSA recommend intravenous metronidazole 500 mg every 8 hours with oral vancomycin 500 mg 4 times per day (and/or 500 mg PR q6h in 100 mL normal saline as a retention enema). [5]

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