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11 This decreased response to metronidazole likely reflects increased severity of disease. In a 2005 editorial, Gerding recommends that the switch to vancomycin also be considered in patients whose leukocytosis worsens during therapy.
13 Modifiable practices that may decrease initial treatment failures include avoiding the use of antimotility agents and discontinuing the causative antibiotic, if possible.
These markers may portend toxic megacolon, imminent intestinal perforation, or fulminant colitis, and they may predict a significantly higher risk of colectomy or death. Empiric therapy should be started for ill patients as soon as C.