Impact of the use of local fidaxomicin treatment algorithms for managing Clostridium difficile infection in hospitalized patients in southeastern United States

Table 2 Clostridium-difficile associated diarrhea treatment pathway using ATLAS scoring (Florida)

ATLAS score	ATLAS classification	First episode	First recurrence	≥ 2 recurrences
0	Mild CDAD	Metronidazole 500 mg PO/IV q8h	Vancomycin 125–250 mg PO q6h	Fidaxomicin 200 mg PO BID or Vancomycin taper^b
1
2
3	Moderate CDAD	Vancomycin 125–250 mg PO q6h	Fidaxomicin 200 mg PO BID	Fidaxomicin 200 mg PO BID or Vancomycin taper^b
4	Moderate CDAD	Vancomycin 125–250 mg PO q6h	Fidaxomicin 200 mg PO BID	Fidaxomicin 200 mg PO BID or Vancomycin taper^b
5	Severe CDAD	Fidaxomicin 200 mg PO BID	Fidaxomicin 200 mg PO BID	Fidaxomicin 200 mg PO BID or Vancomycin taper^b
6
7
8
9
10
Any	Fulminant CDAD^a	Fidaxomicin 200 mg PO BID + Metronidazole 500 mg IV q8h	Fidaxomicin 200 mg PO BID + Metronidazole 500 mg IV q8h	(Fidaxomicin 200 mg PO BID or Vancomycin taper^b) + Metronidazole 500 mg IV q8h

^aCDAD in presence of hypotension/shock (SBP < 90 mmHg requiring vasopressor therapy), ileus, or toxic megacolon
^bVancomycin taper: vancomycin 125 mg PO q6h × 10 days, followed by vancomycin 125 mg PO q12h × 7 days, followed by vancomycin 125 mg PO q24h × 7 days, then vancomycin 125 mg PO every 3 days × 14 days

ISSN: 1476-0711