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Thus, confirmation for toxin B via examinations such as toxin B assay or polymerase chain reaction is necessary when the EIA for toxin A is negative but the common clostridial antigen is positive. In short, clinical judgment is still very important in diagnosis. The standard first-line therapy in both the inpatient and outpatient settings remains oral metronidazole, unless there are contraindications to the medicine such as first trimester elite options binary trading signal software pregnancy or inability to tolerate it.

For severe disease, initial therapy with vancomycin is now recommended ( Table 1 ). In all patients with CDAD, inciting antibiotics should be discontinued, if possible, or changed to a regimen with a narrower spectrum.

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