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Dosing: Adult Antimicrobial Dosing, Non-dialysis
| Indication | Dose | Notes |
|---|---|---|
| Clostridioides difficile infection: initial episode, non-fulminant | 125 mg PO QID | No renal dose adjustment |
| Clostridioides difficile infection: fulminant | 500 mg PO QID* |
Dosing: Antimicrobial Dosing in Intermittent & Continuous Hemodialysis
| Indication | Dose | Notes |
|---|---|---|
| Clostridioides difficile infection: non-fulminant | 125 mg PO QID | No dose adjustment in hemodialysis |
| Clostridioides difficile infection: fulminant | 500 mg PO QID |
Dialysis Notes
Intermittent HD assumes high-flux hemodialysis. CRRT assumes CVVHD with ultrafiltration rate 2L/h and residual native GFR < 10 mL/min. For detailed view of dialysis dosing and evidence, see Dosing in Hemodialysis document.
*Consider additional rectal instillation
See IDMP guidelines for greater detail and vancomycin taper dosing: https://idmp.ucsf.edu/content/management-clostridium-difficile-infection-adults
PO vancomycin is NOT sufficiently absorbed to treat systemic infections