ACG Guidelines: Vancomycin as Prophylactic

The American College of Gastroenterology released new guidelines recently. They’re not terribly exciting, and we’ve talked before about how the treatment guidelines differ from those of the The Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). ACG still recommends Vancomycin as first line while IDSA and SHEA went ahead and bumped Dificid to the front of the line. The difference being negligible really, and doctors from both saying either set of guidelines could really be equally effective.

But what I did find interesting here (that I don’t think we’ve discussed) is that they are finally officially recommending Vancomycin as a prophylactic for people with a history of CDI. This should make it easier to convince doctors to give this treatment alongside post-CDI antibiotic use. Some doctors have still been reluctant to do this despite research showing it works (which we’ve talked about before). And many flat-out refuse to do it.

From the article:

“In patients with a history of CDI who are at an increased risk for recurrence, to prevent further recurrence, oral vancomycin prophylaxis (OVP) may be considered during subsequent systemic antibiotic use. When prescribing OVP, using low-dose vancomycin 125 mg once daily is suggested. In most cases, this treatment is continued until 5 days following completion of systemic antibiotics.”


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