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C. difficile Infection (CDI) Testing Algorithm: PCR/Reflex ...

C. difficile Infection (CDI) Testing Algorithm: PCR/Reflex Toxin EIA (5/14/2021) >3 observed watery stools within 24 hours Alternate explanation ( laxative, PO contrast)? DO NOT ORDER C. difficile PCR If diarrhea-causing medication present, stop medication and re-evaluate in 24-48 hours C. diff PCR previously sent within 7 days? Was prior test positive? DO NOT SEND C. difficile PCR FOR TEST-OF-CURE If diarrhea improving, continue current management. If diarrhea worsening: - Escalate therapy - Consider ID consult ORDER Stool C. difficile PCR YES YES YES YES NO NO NO NO Reflex to C. difficile Toxin EIA C. difficile PCR NEGATIVE CDI unlikely Consider other etiologies of diarrhea. C. difficile Toxin EIA NEGATIVE Indeterminate result In most cases, do not treat for CDI. Consider the patient colonized with C. difficile bacteria. Reevaluate for alternative causes of diarrhea. If strong clinical suspicion for CDI persists, treat and consider ID consultation.

May 14, 2021 · In most cases, do not treat for CDI. Consider the patient colonized with C. difficile bacteria. Reevaluate for alternative causes of diarrhea. If strong clinical suspicion for CDI persists, treat and consider ID consultation. Stop unnecessary oral/IV antibiotics. Order Contact Plus isolation C. difficile Toxin EIA POSITIVE

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