What treatments are effective for C difficile colitis in adults?
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What treatments are effective for C difficile colitis in adults? Evidence-based answer: Oral metronidazole 500 mg TID or vancomycin 125 mg QID produce cure rates of 71% to 79% in mild to moderate Clostridium difficile infection (CDI); however, oral metronidazole is much less expensive than vancomycin. Evidence is insufficient to determine if probiotics are effective for the treatment of CDI with or without antibiotics (SOR: A, systematic reviews of RCTs). Vancomycin 125 mg QID is preferred for initial or recurrent severe CDI (SOR: C, clinical practice guidelines). Fecal microbiota transplantation can be considered in refractory or recurrent (>3 CDI) cases (SOR: B, systematic review of case series studies). Discontinuing the inciting antibiotic upon diagnosis is also recommended (SOR: C, clinical practice guidelines).
Evidence Based Practice 18(4): 1-2