Management of severe and complicate

Management of severe and complicated CDI
14. Supportive care should be delivered to all patients and includes intravenous fl uid resuscitation, electrolyte replacement, and pharmacological venous
thromboembolism prophylaxis. Furthermore, in the absence of ileus or signifi cant abdominal distention, oral or enteral feeding should be continued.
(Conditional recommendation, low-quality evidence)
15. CT scanning of the abdomen and pelvis is recommended in patients with complicated CDI. (Conditional recommendation, low-quality evidence)
16. Vancomycin delivered orally (125 mg four times per day) plus intravenous metronidazole (500 mg three times a day) is the treatment of choice in
patients with severe and complicated CDI who have no signifi cant abdominal distention. (Strong recommendation, low-quality evidence)
17. Vancomycin delivered orally (500 mg four times per day) and per rectum (500 mg in a volume of 500 ml four times a day) plus intravenous
metronidazole (500 mg three times a day) is the treatment of choice for patients with complicated CDI with ileus or toxic colon and / or signifi cant
abdominal distention. (Strong recommendation, low-quality evidence)
18. Surgical consult should be obtained in all patients with complicated CDI. Surgical therapy should be considered in patients with any one of the
following attributed to CDI: hypotension requiring vasopressor therapy; clinical signs of sepsis and organ dysfunction (renal and pulmonary); mental
status changes; white blood cell count ≥ 50,000 cells / μ l, lactate ≥ 5 mmol / l; or failure to improve on medical therapy after 5 days. (Strong recommendation,
moderate-quality evidence)

Results (Indonesian) 1:

Management of severe and complicated CDI14. Supportive care should be delivered to all patients and includes intravenous fl uid resuscitation, electrolyte replacement, and pharmacological venousthromboembolism prophylaxis. Furthermore, in the absence of ileus or signifi cant abdominal distention, oral or enteral feeding should be continued.(Conditional recommendation, low-quality evidence)15. CT scanning of the abdomen and pelvis is recommended in patients with complicated CDI. (Conditional recommendation, low-quality evidence)16. Vancomycin delivered orally (125 mg four times per day) plus intravenous metronidazole (500 mg three times a day) is the treatment of choice inpatients with severe and complicated CDI who have no signifi cant abdominal distention. (Strong recommendation, low-quality evidence)17. Vancomycin delivered orally (500 mg four times per day) and per rectum (500 mg in a volume of 500 ml four times a day) plus intravenousmetronidazole (500 mg three times a day) is the treatment of choice for patients with complicated CDI with ileus or toxic colon and / or signifi cantabdominal distention. (Strong recommendation, low-quality evidence)18. Surgical consult should be obtained in all patients with complicated CDI. Surgical therapy should be considered in patients with any one of thefollowing attributed to CDI: hypotension requiring vasopressor therapy; clinical signs of sepsis and organ dysfunction (renal and pulmonary); mentalperubahan status; sel darah putih count ≥ 50.000 sel / μ l, laktat ≥ 5 mmol / l; atau kegagalan untuk memperbaiki terapi medis setelah 5 hari. (Rekomendasi kuat,bukti kualitas moderat)