Changes

* Highest PPV (93.5%) Toxin EIA 1 + NAAT

* Highest PPV (93.5%) Toxin EIA 1 + NAAT

==TREATMENT==

=TREATMENT=

-First line treatment

*First line treatment

-PO Vancomycin (78.5% success rate, 25,3% recurrence rate)

*PO Vancomycin (78.5% success rate, 25,3% recurrence rate)

-PO Metronidazole (66,3% success rate, 47% recurrence rate), recent strains have

*PO Metronidazole (66,3% success rate, 47% recurrence rate), recent strains have

higher MIC

higher MIC

-Disease stratification

*Disease stratification

-WBC (15), Cr (1.5% baseline), recurrence, hypotension, ileus, megacolon

*WBC (15), Cr (1.5% baseline), recurrence, hypotension, ileus, megacolon

-Mild = Metronidazole, preferred for cost and non-inferiority in mild disease

*Mild = Metronidazole, preferred for cost and non-inferiority in mild disease

-Severe/Complicated = Vancomycin

*Severe/Complicated = Vancomycin

-Recurrent = Metro or Vanco for first recurrence, Vanco for subsequent

*Recurrent = Metro or Vanco for first recurrence, Vanco for subsequent

-Nener treatments

*Newer treatments

- -Fidazomicin (87.7% success rate vs. 86.8% for vanco, 15.4% recurrence rate)

**Fidazomicin (87.7% success rate vs. 86.8% for vanco, 15.4% recurrence rate)

-=-Expensive

***Expensive

_-Fecal microbiota transplant (83-94% success rate for recurrent COL)

**Fecal microbiota transplant (83-94% success rate for recurrent COL). Fecal microbiota transplantation restores gut microbiota diversity, with the

Fecal microbiota transplantation restores gut microbiota diversity, with the

instillation of donor stool into the gastrointestinal tract of an infected patient, This procedure has had good clinical response without reports of adverse events, for refractory or recurrent COI. The first systematic revien was published in 2911 and

instillation of donor stool into the gastrointestinal tract of an infected patient,

included 317 patients with recurrent COI treated with fecal microbiota transplantation via enema, nasojejunal-tube/gastroscope or colonoscopy. Clinical resolution occurred in 92% of patients (89% after a single treatment), without serious adverse effects. A recent revien of 536 patients reported a 27% clinical response rate.

This procedure has had good clinical response without reports of adverse events, for

refractory or recurrent COI. The first systematic revien was published in 2911 and

included 317 patients with recurrent COI treated with fecal microbiota

transplantation via enema, nasojejunal-tube/gastroscope or colonoscopy. Clinical

resolution occurred in 92% of patients (89% after a single treatment), without

serious adverse effects. A recent revien of 536 patients reported a 27% clinical

response rate.

A randomized trial of fecal microbiota transplantation demonstrated symptom

A randomized trial of fecal microbiota transplantation demonstrated symptom

resolution in 94% of patients who received vancomycin for s days followed by either

resolution in 94% of patients who received vancomycin for s days followed by either