Clostridioides difficile Infection (CDI) Treatment — free guideline decision tool

This tool gives the Clostridioides difficile infection regimen by episode and severity, covering initial, recurrent, and fulminant disease.

Initial (non-severe/severe) → fidaxomicin or oral vancomycin ×. First recurrence → fidaxomicin or vancomycin taper-pulse. Multiple recurrences → taper-pulse/rifaximin/FMT. Fulminant → high-dose vancomycin + IV metronidazole + surgery.

Use to choose fidaxomicin or vancomycin for initial/recurrent CDI, taper-pulse or FMT for multiple recurrences, and high-dose vancomycin + IV metronidazole for fulminant disease.

Metronidazole is no longer a first-line agent and is reserved for non-severe disease only when a preferred drug is unavailable. (original synthesis · not guideline verbatim) A test of cure is not performed, since asymptomatic carriage can persist. Bezlotoxumab may be added to reduce recurrence in high-risk patients.

For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.

Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.

Inputs: Episode First recurrence, Severity Severe (criteria [Pending update]) → Result: Regimen Fidaxomicin/vancomycin taper-pulse（Treatment: First recurrence: if initial was vancomycin/metronidazole → fidaxomicin, or a vancomycin tapered + pulsed regimen; if initial was fidaxomicin → vancomycin taper-pulse or repeat fidaxomicin; high-risk patients may add bezlotoxumab to reduce recurrence, Severity: Severe (criteria [Pending update]): still use fidaxomicin or oral vancomycin, watch closely for progression to fulminant disease, General: Stop inciting antibiotics where possible, avoid antimotility agents; metronidazole only if a first-line drug is unavailable and disease is non-severe; do not perform a test of cure） Inputs: Episode Initial, Severity Non-severe (criteria [Pending update]) → Result: Regimen Fidaxomicin or vancomycin (oral)（Treatment: Initial (non-severe or severe): fidaxomicin(preferred, fewer recurrences) or vancomycin qid PO; both superior to metronidazole, Severity: Non-severe (criteria [Pending update]), General: Stop inciting antibiotics where possible, avoid antimotility agents; metronidazole only if a first-line drug is unavailable and disease is non-severe; do not perform a test of cure）