Clostridium Difficile

Stop unnecessary antibiotics, gastric acid suppressants, laxatives and anti-motility agents.

70% respond to metronidazole in 5 days; 92% in 14 days.

If severe symptoms or signs (below) should treat with oral vancomycin, review progress closely and/or consider hospital referral.

Definition of severe: T >38.5oC, or WCC >15, or rising creatinine (>1.5 x baseline) or signs/symptoms of severe colitis.

1st episode with NO severity markers:


If no response after 5 days switch to oral vancomycin

 400mg three times daily

10-14 days

1st episode with ≥1 severity markers or no response to metronidazole after 5 days (refer to hospital):

oral vancomycin

 125mg four times daily

10-14 days

Second or subsequent recurrence – discuss treatment options with Medical Microbiologist or Infection Specialist.

Refer to local Treatment Guide