علاج عدوى Clostridium difficile بعد انتكاسة مرتين أو أكثر

References

• With the understanding that risk of a subsequent recurrence increases with each episode of CDI, we continue to make a distinction between patients with a first CDI recurrence and those with multiple recurrences (≥2 recurrences).
• For patients with multiple recurrences, vancomycin in a tapered and pulsed regimen, vancomycin followed by rifaximin, and fecal microbiota transplantation are options in addition to fidaxomicin.
• Fidaxomicin 200 mg given twice daily for 10 days, OR twice daily for 5 days followed by once every other day for 20 days
• Vancomycin by mouth in a tapered and pulsed regimen
• Vancomycin 125 mg 4 times daily by mouth for 10 days followed by rifaximin 400 mg 3 times daily for 20 days
• Fecal microbiota transplantation
• The opinion of the panel is that appropriate antibiotic treatments for at least 2 recurrences (ie, 3 CDI episodes) should be tried prior to offering fecal microbiota transplantation