Evaluation and Management of Suspected Clostridium difficile (C. difficile) Infection Pathway Background and Objectives Clostridium difficile is a significant infection that is becoming more common in children. Although most episodes can be treated with initial empiric first line therapies, some patients should receive a pre-emptive escalation of therapy. Further, when recurrence becomes an issue there is increased likelihood of side effects and possible antimicrobial resistance. Alternative therapies are recommended in these situations. The objectives of this pathway are to: Create a systematic way to manage difficile Determine the proper management of difficile based upon individual patient history Algorithm Download C. difficile Pathway Algorithm Quality Metrics Percentage of patients with order set usage Percentage of patients with appropriate testing for diagnosis of C. difficile infection Percentage of patients receiving recommended antibiotics based on severity Average duration of treatment Percentage of patients with relapses within 30 days Percentage of patients who required medication escalation (Metronidazole to Vancomycin, Vanco to Nitazoxanide, Fidaxomycin) Percentage of patients who required escalation to stool transplant Educational Module Download C. difficile Educational Module Key References McDonald LC, Gerding DN, Johnson S, et al. Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis. 2018 Mar;66(7):987-994. Surawicz CM, Brandt LJ, Binion DG, Ananthakrishnan AN, Cury SR, Gilligan PH, McFarland LV, Mellow M, Zuckerbraun BS. Guidelines for Diagnosis, Treatment, and Prevention for Clostridium difficile Infections. Am J Gastroenterol. 2013 Apr;108(4):478-98. Schutze GE, Willoughby RE; Committee on Infectious Diseases; American Academy of Pediatrics. Clostridium difficile infection in infants and children. Pediatrics. 2013 Jan;131(1):196-200. Pathway Contacts Jennifer Girotto, PharmD, BCPPS Peter Townsend, MD Tracy Creatore, RN Disclaimer The clinical pathways in the above links have been developed specifically for use at Connecticut Children’s and are made available publicly for informational and/or educational purposes only. The clinical pathways are not intended to be, nor are they, a substitute for individualized professional medical judgment, advice, diagnosis, or treatment. Although Connecticut Children’s makes all efforts to ensure the accuracy of the posted content, Connecticut Children’s makes no warranty of any kind as to the accuracy or completeness of the information or its fitness for use at any particular facility or in any individual case. View all Clinical Pathways >
