Guidelines
Clostridioides (Clostridium) difficile associated diarrhea

Clostridioides (Clostridium) difficile associated diarrhea

Clinical/Diagnostic Recommendations

  • Children > 1 year with diarrhea (≥ 3 unformed stools per day) in the setting of current or recent antibiotic therapy or onset of diarrhea after >72 hours of hospitalization.
  • In ambulatory setting, other causes of diarrhea should be been excluded if above conditions are not met.
  • Testing is not recommended in children ≤1 year of age.
  • Screening for and treatment of carriage without symptoms is not recommended.
  • Test of cure is not recommended.

Infection Prevention and Control

Contact Precautions

Precautions to be discontinued only by IPAC.

Pathogens

Empiric Antimicrobials

Discontinue all antimicrobials if possible as this may be sufficient for control of mild disease

Moderate or severe disease (or hospitalized patients or vulnerable population such as oncology patients)

Vancomycin given orally is not absorbed systemically so does not have systemic toxicity.

OR

Metronidazole is systemically absorbed in the small bowel and carries a higher failure rate compared to vancomycin in children.

Severe or recurrent disease or patients with underlying immunosuppression

Usual Duration

Usual duration 10 days , if severe 14 days

If severe or recurrent disease, consult ID