{"id":412,"date":"2023-09-16T22:07:14","date_gmt":"2023-09-16T21:07:14","guid":{"rendered":"https:\/\/microregistrar.com\/?p=412"},"modified":"2023-09-16T22:07:14","modified_gmt":"2023-09-16T21:07:14","slug":"c-difficile-infection-guideline-comparison-between-nice-2021-and-idsa-2021","status":"publish","type":"post","link":"https:\/\/microregistrar.com\/?p=412","title":{"rendered":"C difficile Infection guideline \u2013 comparison between NICE 2021 and IDSA 2021"},"content":{"rendered":"\n

What does NICE guideline 2021 say about assessing and managing C difficile infection?<\/p>\n\n\n\n

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<\/p>\n\n\n\n

Comparison between NICE 2021 guideline and IDSA 2021 update<\/p>\n\n\n\n

<\/td>IDSA\/SHEA focussed update 2021<\/strong><\/td>NICE 2021<\/strong><\/td><\/tr>
1st episode of CDAD -1st line<\/td>Fidaxomicin 200 mg BO PO 10 days<\/td>Vancomycin 125 mg QDS PO 10 days<\/td><\/tr>
1st episode of CDAD – 2nd line<\/td>Vancomycin 125 mg QDS PO 10 days<\/td>Fidaxomicin 200 mg BO PO 10 days<\/td><\/tr>
1st episode of CDAD – Non-severe CDAD or above agents not available<\/td>Metronidazole 500 mg TDS PO 14 days<\/td><\/td><\/tr>
1st episode of CDAD -1st and 2nd line ineffective<\/td><\/td>Vancomycin Upto 500 mg QDS PO 10 days +\/-
Metronidazole 500 mg IV TDS 10 days [2]<\/td><\/tr>
1. Fidaxomicin 200 mg BO PO 10 days [1] OR,
2. Fidaxomicin BO PO 5 days followed by once every other day for 20 days [1] OR,
3. Vancomycin by mouth in a tapered and pulsed regimen [1] OR,
4.Vancomycin 125 mg 4 times daily by mouth for 10 days followed by rifaximin 400 mg 3 times daily for 20 days [1] OR,
5. Fecal microbiota transplantation [5]<\/td>		<\/td>Fidaxomicin 200 mg BO PO 10 days<\/td><\/tr>
Further episodes after 12 weeks (recurrence)<\/td><\/td>1. Vancomycin 125 mg QDS PO 10 days OR,
2. Fidaxomicin 200 mg BO PO 10 days<\/td><\/tr>
1st C diff recurrence 1st line<\/td>1. Fidaxomicin 200 mg BO PO 10 days [1] OR,
2. Fidaxomicin BO PO 5 days followed by once every other day for 20 days [1]<\/td>		<\/td><\/tr>
1st C diff recurrence 2nd line<\/td>1. Vancomycin by mouth in a tapered and pulsed regimen [1,4] OR,
2. Vancomycin 125 mg QDS PO 10 days [1]<\/td>		<\/td><\/tr>
2nd or subsequent recurrence<\/td>Appropriate antibiotic treatments for at least 2 recurrences (ie, 3 CDI episodes) should be tried prior to offering faecal microbiota transplantation.<\/td><\/td><\/tr>
Vancomycin 500 mg 4 times daily by mouth or by nasogastric tube. If ileus, consider adding rectal instillation of vancomycin. Intravenously administered metronidazole (500 mg every 8 hours) should be administered together with oral or rectal vancomycin, particularly if ileus is present.<\/td>Life-threatening C difficile infection\/ Fulminant C difficile infection<\/td>Vancomycin Upto 500 mg QDS PO 10 days+\/-
Metronidazole 500 mgIV TOS 10 days [3]<\/td><\/tr>
Faecal microbiota transplantation<\/td>Appropriate antibiotic treatments for at least 2 recurrences (i.e., 3 CDI episodes) should be tried before offering faecal microbiota transplantation.<\/td>Recurrent episode of infection after 2 or more previous episodes<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n
[1]<\/td>Adjunctive treatment (with fidaxomicin or vancomycin): Bezlotoxumab 10 mg\/kg given intravenously once during the administration of soc antibiotics. Data, when combined with fidaxomicin, are limited. caution for use in patients with congestive heart failure<\/td><\/td><\/tr>
[2]<\/td>Adjunctive treatment (with fidaxomicin or vancomycin): Bezlotoxumab 10 mg\/kg given intravenously once during the administration of soc antibiotics. Data, when combined with fidaxomicin, are limited. Caution for use in patients with congestive heart failure<\/td><\/td><\/tr>
[3]<\/td>Seek specialist opinion, may need surgery<\/td><\/td><\/tr>
[4]<\/td>Tapered\/pulsed vancomycin regimen: 125 mg 4 times daily for 1 14 days, 2 times daily for 7 days, once daily for 7 days, and then every 2 to 3 days for 2 to 8 weeks<\/td><\/td><\/tr>
[5]<\/td>Appropriate antibiotic treatments for at least 2 recurrences (ie, 3 CDI episodes) should be tried prior to offering faecal microbiota 
transplantation<\/td>		<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n
\n
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\"\"<\/figure>\n<\/figure>\n","protected":false},"excerpt":{"rendered":"

What does NICE guideline 2021 say about assessing and managing C difficile infection? Comparison between NICE 2021 guideline and IDSA […]<\/p>\n","protected":false},"author":1,"featured_media":413,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ngg_post_thumbnail":0,"footnotes":""},"categories":[133],"tags":[135,134,136],"class_list":["post-412","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-guideline","tag-c-difficile","tag-guideline","tag-nice"],"_links":{"self":[{"href":"https:\/\/microregistrar.com\/index.php?rest_route=\/wp\/v2\/posts\/412","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/microregistrar.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/microregistrar.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/microregistrar.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/microregistrar.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=412"}],"version-history":[{"count":2,"href":"https:\/\/microregistrar.com\/index.php?rest_route=\/wp\/v2\/posts\/412\/revisions"}],"predecessor-version":[{"id":417,"href":"https:\/\/microregistrar.com\/index.php?rest_route=\/wp\/v2\/posts\/412\/revisions\/417"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/microregistrar.com\/index.php?rest_route=\/wp\/v2\/media\/413"}],"wp:attachment":[{"href":"https:\/\/microregistrar.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=412"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/microregistrar.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=412"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/microregistrar.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=412"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}