Fulminant

  • toxic megacolon

  • hypotension

  • shock

Usual Pathogens

Clostridioides difficile

 

Empiric Therapy Dose Duration
Vancomycin 125mg PO/NG qid 10 days
+    
Metronidazole IV 500mg IV q8h Until patient is no longer critically ill (usually 5-7 days)

If ileus, add

Empiric Therapy Dose Duration
Vancomycin PR 500mg PR qid 10 days