Oral vancomycin for antibiotic-associated pseudomembranous colitis

Area of Science:

• Gastroenterology
• Infectious Diseases
• Pharmacology

Background:

• Antibiotic-associated pseudomembranous colitis is a severe gastrointestinal condition.
• Persistent symptoms often occur despite antimicrobial discontinuation.
• Clostridial toxins are implicated in the pathogenesis.

Purpose of the Study:

• To evaluate the efficacy of oral vancomycin for persistent antibiotic-associated pseudomembranous colitis.
• To assess clinical and sigmoidoscopic outcomes in patients refractory to prior treatment.

Main Methods:

• Nine patients with confirmed pseudomembranous colitis received oral vancomycin (2 g daily).
• Patients had severe diarrhea and endoscopic lesions despite prolonged antimicrobial withdrawal.
• Clinical response, toxin levels, and sigmoidoscopic findings were monitored.

Main Results:

• All nine patients demonstrated a good clinical response, with diarrhea resolving within 7 days.
• Stool toxin concentrations decreased rapidly during vancomycin treatment.
• Sigmoidoscopy showed significant improvement or complete resolution of lesions in seven patients after 7-10 days.

Conclusions:

• Oral vancomycin is an effective treatment for antibiotic-associated pseudomembranous colitis persisting despite antimicrobial cessation.
• High concentrations of vancomycin in stool suggest a localized therapeutic effect.
• Vancomycin offers a valuable therapeutic option for refractory cases.