Oral vancomycin hydrochloride therapy for postoperative methicillin-cephem-resistant Staphylococcus aureus enteritis

The postoperative development of methicillin-cephem-resistant Staphylococcus aureus (MRSA) enteritis can be fatal unless it is detected at an early stage and treated with effective antibacterial agents. We report herein a Japanese multicenter collaborative clinical study on the efficacy and safety o...

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Bibliographic Details
Published in:Surgery today (Tokyo, Japan) Japan), 1997-01, Vol.27 (9), p.826
Main Authors: Konishi, T, Idezuki, Y, Kobayashi, H, Shimada, K, Iwai, S, Yamaguchi, K, Shinagawa, N
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents - administration & dosage
Anti-Bacterial Agents - pharmacology
Cephalosporins - pharmacology
Dose-Response Relationship, Drug
Drug Resistance, Microbial
Enteritis - drug therapy
Enteritis - microbiology
Female
Humans
Male
Methicillin Resistance
Middle Aged
Postoperative Complications
Staphylococcus aureus - drug effects
Treatment Outcome
Vancomycin - administration & dosage
Vancomycin - pharmacology
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Summary:The postoperative development of methicillin-cephem-resistant Staphylococcus aureus (MRSA) enteritis can be fatal unless it is detected at an early stage and treated with effective antibacterial agents. We report herein a Japanese multicenter collaborative clinical study on the efficacy and safety of oral vancomycin hydrochloride (VCM) in the treatment of MRSA enteritis. A total of 49 patients who had been diagnosed as having, or were strongly suspected of having, MRSA enteritis during the early postoperative period, were given oral VCM as four standard doses of 0.5 g per day. The VCM concentrations in the blood, urine, and feces were then measured. No side effects were observed and the clinical efficacy of oral VCM in the 31 evaluable patients was excellent. There was a 100% clinical response rate and a 95.8% bacterial elimination rate in the feces. The clinical complete response (CR) rate to oral VCM differed significantly between patients in whom MRSA was detected only in the feces (100%) and those in whom MRSA was isolated from an additional source (57%) (P < 0.01). Although VCM concentrations in the stools were extremely high, the levels in the blood and urine were very low. These results demonstrate that oral VCM should be the treatment of choice for postoperative MRSA enteritis due to its safety and efficacy.
ISSN:0941-1291
DOI:10.1007/BF02385273