Antimicrobial ReportsChanges in Metronidazole and Vancomycin Utilization for Nonsevere Clostridioides difficile Infection Among Institutions Caring for ChildrenStultz, Jeremy S. PharmD*,†; Hopp, Jaclyn PharmD‡; Orndahl, Christine M. BS§; Omecene, Nicole E. PharmD¶; Pakyz, Amy L. PharmD, PhD¶Author Information From the *Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center, Memphis, TN †Department of Pharmacy, Le Bonheur Children’s Hospital, Memphis, TN ‡Department of Pharmaceutical Sciences, St. Jude Children’s Research Hospital, Memphis, TN §Department of Biostatistics, Virginia Commonwealth University, Richmond, VA ¶Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, VA. Accepted for publication January 23, 2021 The authors have no funding or conflicts of interest to disclose. Address for correspondence: Jeremy Stultz, PharmD, BCPPS, Department of Clinical Pharmacy and Translational Science, Clinical Pharmacy Specialist—Antimicrobial Stewardship, Le Bonheur Children’s Hospital, 881 Madison Ave., Room 223, Memphis TN 38163. E-mail: [email protected]. The Pediatric Infectious Disease Journal: July 2021 - Volume 40 - Issue 7 - p 634-636 doi: 10.1097/INF.0000000000003117 Buy Metrics Abstract Clostridioides difficile infection guidelines were published in final format on April 1, 2018. Among 4962 and 3545 C. difficile infection cases in children the year before and after publication, oral metronidazole use decreased from 63.0% to 44.3% (P < 0.001) and oral vancomycin use increased from 27.3% to 47.7% (P < 0.001). Quarterly metronidazole utilization decreased postguidelines among 117 institutions, incidence rate ratios 0.86 (95% confidence intervals: 0.78–0.96). Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.