Clostridium Difficile Infection (CDI)

Most likely pathogen

Note

Stop all other antibiotics if possible.

See “IWK Pediatric Clostridium Difficile Guidelines” > Pulse > Quick Links > Antimicrobial Stewardship Website

Testing is not recommended in children < 1 year of age. In children 1-2 years of age, testing is not routinely recommended unless other infectious and noninfectious causes have been excluded.
Discontinue all other antimicrobials if possible as this may be sufficient for mild disease.

Duration of therapy

10 days
(10-14 days if severe complicated or second recurrence, consult ID)

Consult

If severe, complicated or recurrent disease, consult Infectious Disease

If Mild : < 4 abnormal stools per day and no evidence of systemtic toxicity, discontinue precipitating antibiotic with adequate follow up assessment only.

If Moderate: > 4 abnormal stools per day; no evidence of systemic toxicity) OR Mild that is not responding to discontinuation of precipitating agent; Suggested regimens below:

OR

If Severe uncomplicated: evidence of systemic toxicity (high grade fever, rigors, severe abdominal pain, tenderness or distention)