C. diff & ICU Diarrhea

Infection & Sepsis · ICU Decoded chapter 42 · Free in full

Cited to IDSA/SHEA 2017; ACG 2021.

Key points

CDI is suspected after antibiotic exposure with ≥3/24 h liquid stools; only test unformed stool (NAAT ± toxin).
Non-severe disease: fidaxomicin 200 mg BD (preferred — lower recurrence) or vancomycin 125 mg PO QID ×10 d; severe/fulminant: vanc PO + IV metronidazole ± surgical review.
Use contact precautions and soap-and-water handwashing, since spores resist alcohol gel.
Fulminant disease (megacolon, lactate ≥5, WBC >50): get an early colectomy consultation.

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