title: Chromatographically purified vancomycin: therapy of serious infections caused by Staphylococcus aureus and other gram-positive bacteria.
abstract: Fourteen patients with serious infections caused by Staphylococcus aureus and other gram-positive bacteria were prospectively treated with chromatographically purified vancomycin in an open-label, nonrandomized study, between December 1986 and June 1987. Five patients were excluded from the evaluation of efficacy. Among the nine evaluable patients, cure was achieved in six patients--a success rate of 67%. One patient had a relapse of osteomyelitis, and cultures of draining pus were positive for oxacillin-resistant S aureus within three weeks after the discontinuation of vancomycin therapy. One patient failed to respond to vancomycin therapy for S aureus-induced endocarditis, meningitis, and osteomyelitis; in another patient, the treatment failed to reverse the course of S aureus septicemia. No serious drug toxicity, for example, nephrotoxicity, was encountered in any patient. One patient (7%) experienced mild ototoxicity. Four patients (29%) had mild phlebitis, two patients (14%) had a transiently positive Coombs' test, and one patient (7%) had a "red neck syndrome" and "pain and spasm syndrome." Chromatographically purified vancomycin is an effective antibiotic in the treatment of serious infections caused by susceptible gram-positive bacteria. Some minor side effects of vancomycin may not be due to impurities in the preparation but rather to the vancomycin itself.
authors.affiliation: Department of Medicine, Veterans General Hospital, Taipei, Taiwan, Republic of China.
authors.forename: L S
authors.initials: LS
authors.lastname: Wang
authors.forename: C Y
authors.initials: CY
authors.lastname: Liu
authors.forename: F D
authors.initials: FD
authors.lastname: Wang
authors.forename: C P
authors.initials: CP
authors.lastname: Fung
authors.forename: Z H
authors.initials: ZH
authors.lastname: Chiu
authors.forename: D L
authors.initials: DL
authors.lastname: Cheng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002845:Chromatography; D004352:Drug Resistance, Microbial; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010068:Oxacillin / Q000494:pharmacology; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy*; D013211:Staphylococcus aureus; D014640:Vancomycin / Q000009:adverse effects / Q000302:isolation & purification / Q000627:therapeutic use*
chemical_list: D014640:Vancomycin; D010068:Oxacillin