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Rajesh_Chawla_-_ICU_Protocols_A_stepwise_approa[1].pdf
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M.K. Goenka and N.D. Kapoor

 

 

¥For C. difficile, initiate oral vancomycin (125Ð500 mg QID) or metronidazole (250Ð500 mg TDS, QID) for 10Ð14 days. Probiotics (Lactobacillus GG, S. boulardii) and prolonged course of vancomycin are required for relapsers. In most cases, treatment is started empirically as it takes time for the C. difficile toxin in stool report to come in positive. Consider oral rifaximin and Þdaxomicin in recurrent C. difÞcile.

Suggested Reading

1.Cohen SH, Gerding DN, Johnson S, Kelly CP, et al. Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA). Infect Control Hosp Epidemiol. 2010;31(5):431Ð55.

This guideline updates recommendations regarding epidemiology, diagnosis, treatment, and infection control and environmental management of Clostridium difficile infection.

2.ASGE Standards of Practice Committee, Shen B, Khan K, Ikenberry SO, Anderson MA, Banerjee S, Baron T, et al. ASGE guidelines. The role of endoscopy in the management of patients with diarrhea. GIE. 2010;71(6):887Ð92.

3.Schiller LR. Diarrhea and malabsorption in the elderly. Gastroenterol Clin N Am. 2009; 38:481Ð502.

This article reviews the impact of diarrhea in the elderly, many of whom are less fit physiologically to withstand the effect of diarrhea on fluid balance and nutritional balance.

4.Bartlet JG. Clinical practice. Antibiotic-associated diarrhea. N Engl J Med. 2002;346:334Ð9.

This study discusses various issues related to antibiotic-associated diarrhea.

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