What is the first-line treatment for non-severe C. diff?

Fidaxomicin 200 mg BID × 10 days is preferred over vancomycin 125 mg QID × 10 days for non-severe CDI due to lower recurrence rates. Metronidazole is no longer recommended as first-line therapy per 2021 IDSA guidelines.

How is fulminant C. diff treated?

Fulminant CDI requires high-dose oral vancomycin 500 mg QID + IV metronidazole 500 mg TID. If ileus is present, vancomycin rectal enemas should be added. Early surgical consultation is essential, and FMT may be considered for multiple recurrences.

Clostridioides difficile Infection Severity

Classifies CDI severity per IDSA/SHEA 2021: Non-severe — WBC ≤15,000/µL and serum creatinine <1.5 mg/dL. Severe — WBC >15,000/µL or creatinine ≥1.5 mg/dL. Fulminant — hypotension, shock, ileus, or toxic megacolon.

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Clostridioides difficile Infection Severity

Frequently Asked Questions

What is the first-line treatment for non-severe C. diff?

How is fulminant C. diff treated?