Restricted to use by GI and infectious disease in outpatient setting meeting criteria for use.  Case review by pharmacist is planned for each patient; notify AMT pharmacist when drug is ordered.  If ordered for an inpatient by approved prescribers, contact AMT pharmacist for review. 

For other MDs, contact to discuss and interchange to IVIG in both inpatient and outpatient setting. INTERCHANGE IS NOT AUTOMATIC. Physician may decide on an alternative therapy.

Must be administered before the end of active anti-CDI therapy, and one or more of the below criteria must be met.

Criteria for use:

1. Recurrent CDI (2 or more episodes of CDI)

            OR

     2. At least 2  of the following risk factors for recurrence:

- Age >= 65

- Severe/fulminant* CDI

- Concomitant broad spectrum antibiotic utilization for another infection during treatment of CDI

- Immunocompromised (hematopoletic stem cell transplantation, use of immunosuppressive agents, active

malignancy, solid organ transplant)

*Definitions:

 - Severe CDI: WBC count > 15 x 109/L OR creatinine > 1.5 mg/dL

 - Fulminant CDI: Hypotension, schock, ileus, or megacolon

Reviewed: 26 Sept 2017 (Zinplava), 28 April 2020

• Micromedex
• UpToDate
• Lippincott Advisor