The rapid spread of a particularly virulent strain of Clostridium difficile has prompted the development of new clinical guidelines that focus on how physicians should tailor treatment based on patients' disease severity.
Earlier guidelines, published 15 years ago, suggested that metronidazole and vancomycin were equally effective treatment for patients with C difficile infection. But clinical data that have emerged following recent reports of increased incidence, more severe symptoms, and higher death rates from C difficile demonstrated the need to reexamine existing treatment recommendations.
Voelker R. Increased Clostridium difficile Virulence Demands New Treatment Approach. JAMA. 2010;303(20):2017-2019. doi:10.1001/jama.2010.647