Consider ID consult if risk factors for recurrence are present (age ≥ 65, immunocompromised, severe CDI, chronic PPI use) so patient can be assessed for ambulatory bezlotoxumab referral (restricted to ID)
Fidaxomicin Extended-Pulsed 200 mg PO BID x 5 days, followed by 200 mg PO QOD x 20 days (10 doses), OR
Fidaxomicin 200 mg PO BID x 10 days, OR
Vancomycin PO Taper
Note:
Consider extended-pulsed regimen unless compliance following discharge is a concern
Consider a vancomycin taper in the setting of previous fidaxomicin failure or access/cost issues
It will take several business days to determine if copay assistance is available. If selecting fidaxomicin, consider sending a prescription to Specialty pharmacy upon initiation of therapy to begin processing. Search ‘fidaxomicin’ on Point MultiCare for detailed instructions.Fidaxomicin (Dificid) Specialty Rx Instructions