Antimicrobial prescribing: NHS Forth Valley
Important: Therapy
Metronidazole PO for 10 days
or
Vancomycin PO for 10 days
Notes:
Maintain accurate stool chart
C difficile Infection (Antibiotic Associated Colitis)
Micro Organisms
C difficile
Important: Therapy
Vancomycin PO for 10 days
Add IV metronidazole if ileus or hypotension
CONSIDER URGENT SURGICAL REVIEW
Notes:
Maintain accurate stool chart
Consider systemic antibiotics (Vancomycin IV + gentamicin IV + metronidazole IV) if severe colonic inflammation in addition to above therapy
Important: Notes
Observe bowel movements, symptoms, (WCC and hypotension) and fluid balance. If symptoms continue to worsen, refer to gastroenterology / surgery, and discuss with microbiology.
Ensure infection control measures are in place including stool chart - do no wait for confirmation of diagnosis
Send stool sample
Stop and (non-Clostridium difficile) antimicrobial treatment in patients with CDI if possible
Stop any antimotility agents, laxatives and gastric acid suppressants if possible
Rehydrate patient
Assess symptoms and severity of disease on a daily basis