Discontinue other antibiotics when possible
Discontinue treatments which create diarrhea
Discontinue proton-pump inhibitors when possible
Treat fulminant CDAD empirically, pending confirmation of the diagnosis
Shock, ileus or megacolon
Second or further recurrence
First test of stool is multiplex PCR.
If PCR detects C.difficile DNA, then toxin is tested.
If DNA is detected but toxin is not detected, the patient is colonized and does not require treatment for C.difficile.