SCCM Podcast SCCM Pod-385 Clostridium difficile
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May 22, 2019 In this insightful discussion, Dr. Paula Ferrada, a leading expert in surgical critical care, shares her expertise on managing Clostridium difficile infections. She emphasizes the shift towards vancomycin as a first-line treatment and the crucial role of teamwork between surgical and medical teams. Dr. Ferrada highlights the need for early consultations and the importance of clear communication with families. She also delves into surgical strategies, advocating for international trials to improve long-term outcomes, and stresses the significance of multidisciplinary collaboration in patient care.
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Follow 2018 First-Line Treatment
- Use oral vancomycin (125–120 mg Q6h) as first-line therapy for C. difficile per 2018 guidelines.
- Reserve metronidazole (Flagyl) only when necessary as it is no longer first-line due to resistance.
Aggressive Medical Therapy For Fulminant Disease
- For fulminant C. difficile give high-dose oral and rectal vancomycin and IV metronidazole as aggressive medical therapy.
- Consider surgical consultation early since fulminant disease may require operative intervention.
Bring Surgeons In Early
- Consult surgery early in severe C. difficile before multi-organ failure becomes irreversible.
- Work collaboratively with infectious disease and intensivists to improve patient outcomes.