Patients with severe diarrhea, symptoms that persist despite appropriate outpatient management, or those with a systemic response (fever, leukocytosis, severe abdominal pain) should be hospitalized. Patients with pseudomembranous colitis who are suspected of having a toxic megacolon or perforation should have an immediate surgical consultation. For those patients who are discharged, discontinuation of any antibiotics and good oral intake must be encouraged. The decision to institute therapy using metronidazole or vancomycin should be made in conjunction with the patient's primary physician.
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