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.
(10-14 days if severe complicated or second recurrence, consult ID)
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:
Metronidazole 30 mg/kg/24h PO divided q6h
Maximum: 2 grams/24h
for 10 days
If Severe uncomplicated: evidence of systemic toxicity (high grade fever, rigors, severe abdominal pain, tenderness or distention)
Vancomycin 40 mg/kg/24h PO divided q6h
Maximum: 125 mg/dose OR 500 mg/24h
for 10 days