Adjunctive Intracolonic Vancomycin for Severe Clostridium difficile Colitis: Case Series and Review of the Literature

Successful treatment of severe Clostridium difficile colitis has been reported with the use of adjunctive intracolonic vancomycin (ICV) therapy. We report a descriptive case series and review the literature on patients with C. difficile colitis who received adjunctive ICV therapy. Nine patients rece...

Full description

Saved in:
Bibliographic Details
Published in:Clinical infectious diseases 2002-09, Vol.35 (6), p.690-696
Main Authors: Apisarnthanarak, Anucha, Razavi, Behzad, Mundy, Linda M.
Format: Article
Language:English
Subjects:
Abdominal pain
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents - therapeutic use
Antibacterial agents
Antibiotics
Antibiotics. Antiinfectious agents. Antiparasitic agents
Bacterial diseases
Bacterial diseases of the digestive system and abdomen
Biological and medical sciences
Clostridium difficile
Colitis
Colitis - diagnostic imaging
Colitis - drug therapy
Colitis - physiopathology
Cytotoxins
Diarrhea
Dosage
Drug Administration Routes
Enterocolitis, Pseudomembranous - diagnostic imaging
Enterocolitis, Pseudomembranous - drug therapy
Epidemiology
Female
Human bacterial diseases
Humans
Ileus
Infections
Infectious diseases
Major Articles
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Radiography
Risk Factors
Treatment Outcome
Vancomycin - therapeutic use
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Successful treatment of severe Clostridium difficile colitis has been reported with the use of adjunctive intracolonic vancomycin (ICV) therapy. We report a descriptive case series and review the literature on patients with C. difficile colitis who received adjunctive ICV therapy. Nine patients received antibiotics within 6 weeks prior to presentation. Complete resolution of the clinical presentation occurred in 8 patients (88.9%), and eradication of C. difficile cytotoxin production was documented in 3 (75%) of 4 patients who were tested after the completion of adjunctive ICV therapy. One patient (11.1%) died as a result of progressive multisystem organ failure. In the 6 weeks after the completion of treatment for C. difficile colitis, no patient had recurrent disease, required surgical intervention, or experienced complications from adjunctive ICV therapy. In this case series, administration of adjunctive ICV therapy appeared to be a safe, practical, and effective adjunctive therapy for severe C. difficile colitis.
ISSN:1058-4838
1537-6591
DOI:10.1086/342334