Short-term benefit from oral vancomycin treatment of regressive-onset autism.
In most cases symptoms of autism begin in early infancy. However, a subset of children appears to develop normally until a clear deterioration is observed. Many parents of children with "regressive"-onset autism have noted antecedent antibiotic exposure followed by chronic diarrhea. We speculated that, in a subgroup of children, disruption of indigenous gut flora might promote colonization by one or more neurotoxin-producing bacteria, contributing, at least in part, to their autistic symptomatology. To help test this hypothesis, 11 children with regressive-onset autism were recruited for an intervention trial using a minimally absorbed oral antibiotic. Entry criteria included antecedent broad-spectrum antimicrobial exposure followed by chronic persistent diarrhea, deterioration of previously acquired skills, and then autistic features. Short-term improvement was noted using multiple pre- and post-therapy evaluations. These included coded, paired videotapes scored by a clinical psychologist blinded to treatment status; these noted improvement in 8 of 10 children studied. Unfortunately, these gains had largely waned at follow-up. Although the protocol used is not suggested as useful therapy, these results indicate that a possible gut flora-brain connection warrants further investigation, as it might lead to greater pathophysiologic insight and meaningful prevention or treatment in a subset of children with autism.
Sandler
R H
RH
Section of Pediatric Gastroenterology and Nutrition, Rush Children's Hospital, Rush Medical College, Chicago, IL 60612, USA. rushstudy@aol.com
Finegold
S M
SM
Bolte
E R
ER
Buchanan
C P
CP
Maxwell
A P
AP
Väisänen
M L
ML
Nelson
M N
MN
Wexler
H M
HM
D000284:Administration, Oral; D001321:Autistic Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D001419:Bacteria / Q000254:growth & development; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000382:microbiology; D008297:Male; D009483:Neuropsychological Tests; D012043:Regression, Psychology; D014640:Vancomycin / Q000008:administration & dosage* / Q000009:adverse effects
D014640:Vancomycin