Oral vancomycin is not systemically absorbed, leading to high concentrations in the colon. Administration of 125mg orally every 6 hours to adults provides colonic concentrations higher than the minimum inhibitory concentration for C. difficile. Therefore, higher doses are not necessary.

Due to the expense of the oral vancomycin puvules ($15/125mg capsule), we no longer stock the oral puvules. Instead, when oral vancomycin is ordered, we will provide an oral solution (25mg/ml) prepared using the intravenous formulation, which has been done at many other institutions throughout the United States and is listed as an indication on the package insert.

Unit pharmacists are available to assist in management of CDI. This information has been reviewed and approved by the Antimicrobial Subcomittee.