Case Definition
AND
Testing
Do not send stool for testing if diarrhea not present or ileus
Testing is restricted to one specimen within 7 days due to enhanced detection methods
Toxin testing is NOT a test of cure, and should not be repeated to document resolution of disease
Refer to Scripps C. difficile Testing Algorithm for more in depth explanation of diagnostic testing and interpretations
STOP all other antimicrobial agents whenever possible
If antibiotics required: use shortest recommended duration and most targeted therapy for the organism
Prolonging the duration of CDI treatment until antibiotic regimens have been completed has no known benefit
Use oral therapy whenever possible for treatment of CDI
Efficacy of IV metronidazole monotherapy is not well established
NO efficacy of IV vancomycin for CDI
Probiotics and prophylactic oral vancomycin not recommended for prevention of C. difficile based on limited evidence
Avoid anti-peristaltic agents (loperamide, Lomotil®, etc.) and anion-exchange resins (cholestyramine, colestipol)
Asymptomatic Carriage
Non-Severe
Severe
Fulminant
First Recurrence
Second or Subsequent Recurrence
Reference
2017 Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) guidelines for CDI. Clin Infect Dis 2018.