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C Diff Diarrhea Patients

Page history last edited by Kendall Rogers 7 years, 9 months ago

Best Practice Guidelines for C Diff:

C Diff Diagnosis and Treatment

 


Use of higher dose oral Vancomycin for treatment of C.diff Diarrhea

We have recently had an increase in request for oral Vancomycin 500 mg po QID for treatment of C. diff diarrhea.

Please note the following:

1. Current C.diff guidelines recommend use of higher dose Vancomycin when dealing with complicated severe C. diff diarrhea. Complicated means presence of hypotension or shock, ileus, megacolon. But please note this is a CIII recommendation, which means that there is no good evidence and the recommendation was made by a panel of expert opinion.

2. Higher dose oral Vancomycin leads to low levels of Vancomycin in the blood which allows for the development of resistance of organism such as VRE, VISA, VRSA in that patient.

3. Per Hospitalist Admission plan for C.diff diarrhea, serum Vancomycin levels should be checked when patient is on higher dose oral Vancomycin.

If you start your patient on oral Vancomycin 500 mg po QID, assess daily to see if the diarrhea is improving (not necessarily resolved), and if so, please switch to oral Vancomycin 125 mg po QID for the remainder of the therapy.

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