Oral vancomycin for antibiotic-associated pseudomembranous colitis.
Nine patients with antibiotic-associated pseudomembranous colitis were treated with oral vancomycin. All had severe diarrhoea, tissue-culture evidence of a clostridial toxin in stool, and typical lesions on sigmoidoscopic examination, despite discontinuation of all antimicrobials for periods of 10 days to 8 weeks. Oral vancomycin was given in doses of 2 g daily. All patients showed a good clinical response with gradual resolution of diarrhoea over 7 days and a rapid decrease in concentrations of the toxin in stools. Follow-up sigmoidoscopies in seven patients showed major improvement or complete clearing of lesions after 7-10 days of vancomycin treatment. The mean concentration of vancomycin in twenty-five stools obtained during treatment was 3100 microgram/g, levels in serum being very low. These results suggest a role for oral vancomycin treatment of antibiotic-associated pseudomembranous colitis which persists for extended periods despite discontinuation of the incriminated antimicrobial.
D000284:Administration, Oral; D000667:Ampicillin / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001427:Bacterial Toxins / Q000032:analysis; D002437:Cefazolin / Q000009:adverse effects; D002981:Clindamycin / Q000009:adverse effects; D004761:Enterocolitis, Pseudomembranous / Q000139:chemically induced / Q000188:drug therapy*; D005243:Feces / Q000032:analysis; D006801:Humans; D010406:Penicillins / Q000009:adverse effects; D014640:Vancomycin / Q000008:administration & dosage / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins; D010406:Penicillins; D002981:Clindamycin; D014640:Vancomycin; D000667:Ampicillin; D002437:Cefazolin