Clinical features | Suggested treatment |
First episode | |
Mild or moderate |
|
Severe* |
|
Fulminant¶ |
|
Fulminant¶ disease and ileus |
|
Recurrent episodes | |
First recurrence, mild or moderate |
|
Subsequent recurrence, mild or moderate | Either of the following:
|
IV: intravenous.
* There is no consensus definition of severe C. difficile infection in children. Determination of disease severity should be guided by clinician judgment. We use the following criteria to define severe disease: Fever, profuse diarrhea, abdominal pain and tenderness, abdominal distention, white blood cell count >15,000 cells/microL, elevated age-adjusted creatinine level, serum albumin <2.5 g/dL (25 g/L), and pseudomembranous colitis.
¶ Fulminant disease is characterized by hypotension, shock, ileus, or toxic megacolon.
Δ The optimal dose and volume for rectal vancomycin has not been established for children or adults. Dose and volume adjustments may be required depending upon individual circumstances, extent of colonic disease, and patient weight. Caution is required because perforation is possible with rectal installation of vancomycin.Do you want to add Medilib to your home screen?