To refer a patient to Connecticut Children’s, contact the OneCall team:

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


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

Pathway Contacts

Jennifer Girotto, PharmD, BCPPS
Peter Townsend, MD
Tracy Creatore, RN


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 >

Back to Top
Searching Animation