Clostridium Difficile Colitis admission

Routine Labs

IV Fluids

Electrolyte replacement

Hospitalist:

Med-surgical floor vs Telemetry depending on overall condition

Continue IV fluids if patient has significant diarrhea

Check stool for Cdiff toxin

GI evaluation if needed

Correction of Electrolytes

Monitor for development of Toxic Megacolon->abdominal distension, tenderness, sudden jump in WBC count. Xray or CT scan can be done if suspected, Consult Surgery stat for Toxic Megacolon

Vancomycin liquid 125mg PO Q 6hrs X 10-14 days, tapering over a period of several weeks may be needed if recurrent Cdiff Colitis.

IV Metronidazole 500mg iv Q8hrs if it is severe.

Vancomycin enema, Stool transplantation are options available for recurrent Cdiff Colitis. GI may need to be involved for this.

Earn CME from UpToDate: Clostridioides (formerly Clostridium) difficile infection in adults: Clinical manifestations and diagnosis