Management of mild, moderate, and s

Management of mild, moderate, and severe CDI
6. If a patient has strong a pre-test suspicion for CDI, empiric therapy for CDI should be considered regardless of the laboratory testing result, as the negative predictive values for CDI are insufficiently high to exclude disease in these patients. (Strong recommendation, moderate-quality evidence)
7. Any inciting antimicrobial agent(s) should be discontinued, if possible. (Strong recommendation, high-quality evidence)
8. Patients with mild-to-moderate CDI should be treated with metronidazole 500 mg orally three times per day for 10 days. (Strong recommendation, high-quality evidence)
9. Patients with severe CDI should be treated with vancomycin 125 mg four times daily for 10 days (Conditional recommendation, moderate-quality evidence)
10. Failure to respond to metronidazole therapy within 5 – 7 days should prompt consideration of a change in therapy to vancomycin at standard dosing. (Strong recommendation, moderate-quality evidence)
11. For mild-to-moderate CDI in patients who are intolerant / allergic to metronidazole and for pregnant / breastfeeding women, vancomycin should be used at standard dosing. (Strong recommendation, high-quality evidence)
12. In patients in whom oral antibiotics cannot reach a segment of the colon, such as with Hartman’s pouch, ileostomy, or colon diversion, vancomycin therapy delivered via enema should be added to treatments above until the patient improves. (Conditional recommendation, low-quality evidence)
13. The use of anti-peristaltic agents to control diarrhea from confi rmed or suspected CDI should be limited or avoided, as they may obscure symptoms and precipitate complicated disease. Use of anti-peristaltic