Updates in the Management of Clostridium Difficile for Adults

Vancomycin 125 mg given 4 times daily for 10 days, OR

Fidaxomicin 200 mg given twice daily for 10 days

Alternate if above agents are unavailable: metronidazole 500 mg 3 times per day by mouth for 10 days

Vancomycin 125 mg 4 times per day by mouth for 10 days, OR

Fidaxomicin 200 mg given twice daily for 10 days

Vancomycin 500 mg 4 times per day by mouth or nasogastric tube. If ileus, consider adding rectal instillation of vancomycin. IV metronidazole 500 mg every 8 hours should be administered together with oral or rectal vancomycin, particularly if ileus is present.

Vancomycin 125 mg given 4 times daily for 10 days if metronidazole was used for the initial episode, OR

Use a prolonged tapered and pulsed vancomycin regimen if a standard regimen was used for the initial episode (e.g.,125 mg 4 times per day for 10–14 days; then 2 times per day for a week; then once per day for a week; and then every 2 or 3 days for 2–8 weeks) OR

Fidaxomicin 200 mg given twice daily for 10 days if vancomycin was used for the initial episode

Vancomycin in a tapered and pulsed regimen, OR

Vancomycin 125 mg 4 times per day by mouth for 10 days followed by rifaximin 400 mg 3 times daily for 20 days, OR

Fidaxomicin 200 mg given twice daily for 10 days, OR

Fecal microbiota transplantation