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Granules (for oral suspension) should be used in patients requiring a liquid preparation. Restricted Use - for use when indicated by local trust antimicrobial guidelines, NICE condensed summary table of antimicrobial guidance or specialist microbiology recommendation. For any patient requiring a liquid preparation, fidaxomicin granules should be prescribed. The APC notes that although current NICE guidelines recommend vancomycin first line, it is recognised that this was based on cost and in exceptional cases when a liquid is required, fidaxomicin granules are appropriate to prescribe as a licensed preparation that supports timely treatment.

The Surrey Heartlands integrated care system Area Prescribing Committee (APC) agreed with NICE recommendation not to use bezlotoxumab to prevent recurrence of C. Difficile infection because it is not cost effective. Bezlotoxumab will be given a NON-FORMULARY traffic light status for this indication.