Treatment Guideline Chart
Clostridioides (formerly Clostridium) difficile infection is commonly associated with antibiotic treatment and is one of the most common nosocomial infections.
Symptoms usually start on days 2-3 of antibiotic treatment, but may also occur up to 8-12 weeks after discontinuation of antibiotics.
Discontinuation of antibiotics may be the only measure needed for patients with only mild diarrhea, no fever, no abdominal pain nor a high WBC count.
Cessation of antibiotics allows for reconstitution of the normal colonic microflora and markedly reduces risk of recurrence.

Clostridioides difficile Infection References

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  2. Schroeder MS. Clostridium difficile-associated diarrhea. Am Fam Physician. 2005 Mar;71(5):921-928. PMID: 15768622
  3. Gilbert DN, Moellering RC, Eliopoulos GM, et al. The Sanford Guide to Antimicrobial Therapy. 35th. Hyde Park (VT): Antimicrobial Therapy Inc; 2005.
  4. MedWorm
  5. MedWorm
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  13. Steele SR, McCormick J, Melton GB, et al. Practice parameters for the management of Clostridium difficile infection. Dis Colon Rectum. 2015 Jan;58(1):10-24. doi: 10.1097/DCR.0000000000000289. PMID: 25489690
  14. Kelly CP, Lamont JT. Clostridium difficile in adults: Treatment. UpToDate. Sep 2016. Accessed 10 Nov 2016.
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  16. Lamont JT, Kelly CP, Bakken JS. Clostridioides (formerly Clostridium) difficile infection in adults: clinical manifestations and diagnosis. UpToDate. 09 Dec 2020.
  17. McDonald LC, Gerding DN, Johnson S, et al. Clinical practice guidelines for Clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis. 2018 Mar 19;66(7):e1-e48. doi: 10.1093/cid/cix1085. PMID: 29462280
  18. Michel J, Flores E, Mull N, et al. Translation of a C. difficile treatment clinical pathway into machine-readable clinical decision support artifacts prototyped for electronic health record integration. Agency for Healthcare Research and Quality (AHRQ). Nov 2019.
  19. Sartelli M, Di Bella S, McFarland LV, et al. 2019 update of the WSES guidelines for management of Clostridioides (Clostridium) difficile infection in surgical patients. World J Emerg Surg. 2019;14:8. doi: 10.1186/s13017-019-0228-3. PMID: 30858872
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