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Diarrhoea - antibiotic associated - Management
Additional information
Antibiotic treatment for C. difficile infection
- People with features of severe infection should be managed in secondary care.
- Mild-to-moderate C. difficile infection may be managed in primary care.
- Consult local policy or seek specialist advice if in doubt.
- People with mild disease may not require specific C. difficile antibiotic treatment [DH and HPA, 2008].
- For mild-to-moderate C. difficile infection, metronidazole is recommended first-line because it is as effective as oral vancomycin and is less expensive [DH and HPA, 2008]. As a guide, the Department of Health and Health Protection Agency recommend [DH and HPA, 2008]:
- For the initial episode of C. difficile infection: oral metronidazole 400 mg to 500 mg three times a day for 10–14 days.
- For the first recurrence: repeat the same antibiotic used to treat the initial episode (unless the first episode was treated with metronidazole and the recurrence is severe, in which case vancomycin should be used).
- Vancomycin is reserved for severe C. difficile infection or for subsequent recurrences.
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