scholarly journals RefractoryClostridium difficileInfection Successfully Treated with Tigecycline, Rifaximin, and Vancomycin

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Dominador Lao ◽  
Tom Chiang ◽  
Eric Gomez
Keyword(s):  
Clostridium Difficile ◽  
Standard Therapy ◽  
Case Reports ◽  
Alternative Treatments ◽  
Oral Vancomycin ◽  
Vancomycin Therapy

The occurrence ofClostridium difficilecolitis is on the rise and has become more difficult to manage with standard therapy. Thus, the need for alternative treatments is essential. Tigecycline is a glycylcycline antibiotic that has been shown to be effective againstC. difficilethrough several published case reports and inin vitrostudies. We present a case ofC. difficilecolitis that failed to respond to metronidazole and oral vancomycin therapy, but improved on a combination of rifaximin, tigecycline, and vancomycin.

scholarly journals Struggling with recurrent Clostridium difficile infections: is donor faeces the solution?

2009 ◽  
Vol 14 (34) ◽  
Author(s):  
E van Nood ◽  
P Speelman ◽  
E J Kuijper ◽  
J J Keller
Keyword(s):  
Clostridium Difficile ◽  
Case Reports ◽  
Treatment Options ◽  
Intestinal Flora ◽  
Treatment Strategies ◽  
Case Series ◽  
Oral Vancomycin ◽  
Vancomycin Therapy ◽  
Evidence Based Treatment

Patients with recurrent Clostridium difficile infections (CDI) in hospitals and the community constitute an increasing treatment problem. While most patients with a first infection respond to either metronidazole or oral vancomycin, therapy in recurrent C. difficile infections tends to fail repeatedly. Lack of alternative treatment options can be a tremendous burden, both to patients and their treating physicians. Most guidelines recommend prolonged oral vancomycin pulse and or tapering schedules, but evidence-based treatment strategies are lacking. The role of immunoglobulins, whey prepared from vaccinated cows, probiotics or other antibiotics is unclear. Since 1958 several case series and case reports describe a treatment strategy where faecal infusions are successfully given for the treatment of recurrent CDI. Restoring intestinal flora has been historically thought of as the mechanism responsible for cure in these patients. In the literature, more than 150 patients have received faeces from a healthy donor, either infused through an enema, or through a nasoduodenal or nasogastric tube. We summarise the literature regarding treatment with donor faeces for recurrent CDI, and introduce the FECAL trial, currently open for inclusion.

An Outbreak of Clostridium difficile Necrotizing Enterocolitis: A Case for Oral Vancomycin Therapy?

PEDIATRICS ◽  
1983 ◽  
Vol 71 (6) ◽  
pp. 935-941
Author(s):  
V. K.M. Han ◽  
H. Sayed ◽  
G. W. Chance ◽  
D. G. Brabyn ◽  
W. A. Shaheed
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clostridium Difficile ◽  
Neonatal Intensive Care Unit ◽  
Necrotizing Enterocolitis ◽  
Neonatal Intensive Care ◽  
Oral Vancomycin ◽  
Vancomycin Therapy ◽  
Etiologic Role

During a 2-month period, 13 infants in this neonatal intensive care unit developed necrotizing enterocolitis, increasing the prevalence in inborns from 5.2 to 20.5/1,000 live births. Fifty-seven perinatal and neonatal factors, many of which have previously been associated with necrotizing enterocolitis, were compared between the infants with necrotizing enterocolitis and 17 unaffected inborn control infants admitted concurrently. Clostridium difficile cytotoxin was detected in the stools of 12 affected infants (92.3%) in comparison with two control infants (11.8%) (P < .001), and the organism was isolated in eight affected neonates (61.5%) compared to none of the control infants (P < .001). The outbreak was terminated upon institution of oral vancomycin therapy in cases and infant contacts, and strict antiinfective measures in the neonatal intensive care unit. This indicates an etiologic role of C difficile in the outbreak. Oral vancomycin in the management of necrotizing enterocolitis was assessed by therapeutic response, drug levels, and occurrence of side effects. Oral vancomycin therapy is indicated in necrotizing enterocolitis outbreaks in units where C difficile is endemic.

scholarly journals Economic Barriers in the Treatment of Clostridium difficile Infection With Oral Vancomycin

2017 ◽  
Vol 4 (2) ◽  
Author(s):  
Kristen L. Bunnell ◽  
Larry H. Danziger ◽  
Stuart Johnson
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Outpatient Setting ◽  
Oral Vancomycin ◽  
Vancomycin Therapy ◽  
Economic Barriers

Abstract Vancomycin is an increasingly important option for the treatment of Clostridium difficile infection, but economic barriers to its use remain significant in the outpatient setting. Generic vancomycin capsules are still inexplicably expensive and not universally covered by insurers. This report highlights the potential adverse consequences of cost-related nonadherence to vancomycin therapy and the challenges that clinicians face when prescribing oral vancomycin.

422 ORAL VANCOMYCIN THERAPY IS ASSOCIATED WITH IBD CLINICAL REMISSION IN PEDIATRIC PSC-IBD

2021 ◽  
Vol 160 (6) ◽  
pp. S-88
Author(s):  
Amanda Ricciuto ◽  
Kuan Liu ◽  
Achiya Z. Amir ◽  
Madeleine Aumar ◽  
Annemarie Broderick ◽  
...  
Keyword(s):  
Clinical Remission ◽  
Oral Vancomycin ◽  
Vancomycin Therapy

scholarly journals Characterizations of Clinical Isolates of Clostridium difficile by Toxin Genotypes and by Susceptibility to 12 Antimicrobial Agents, Including Fidaxomicin (OPT-80) and Rifaximin: a Multicenter Study in Taiwan

2012 ◽  
Vol 56 (7) ◽  
pp. 3943-3949 ◽  
Author(s):  
Chun-Hsing Liao ◽  
Wen-Chien Ko ◽  
Jang-Jih Lu ◽  
Po-Ren Hsueh
Keyword(s):  
Clostridium Difficile ◽  
Care Setting ◽  
Antimicrobial Agents ◽  
Teaching Hospitals ◽  
Binary Toxin ◽  
Content Type ◽  
Vancomycin Mics ◽  
Major Teaching ◽  
Southern Taiwan

ABSTRACTA total of 403 nonduplicate isolates ofClostridium difficilewere collected at three major teaching hospitals representing northern, central, and southern Taiwan from January 2005 to December 2010. Of these 403 isolates, 170 (42.2%) were presumed to be nontoxigenic due to the absence of genes for toxins A or B or binary toxin. The remaining 233 (57.8%) isolates carried toxin A and B genes, and 39 (16.7%) of these also had binary toxin genes. The MIC90of all isolates for fidaxomicin and rifaximin was 0.5 μg/ml (range, ≤0.015 to 0.5 μg/ml) and >128 μg/ml (range, ≤0.015 to >128 μg/ml), respectively. All isolates were susceptible to metronidazole (MIC90of 0.5 μg/ml; range, ≤0.03 to 4 μg/ml). Two isolates had reduced susceptibility to vancomycin (MICs, 4 μg/ml). Only 13.6% of isolates were susceptible to clindamycin (MIC of ≤2 μg/ml). Nonsusceptibility to moxifloxacin (n= 81, 20.1%) was accompanied by single or multiple mutations ingyrAandgyrBgenes in all but eight moxifloxacin-nonsusceptible isolates. Two previously unreportedgyrBmutations might independently confer resistance (MIC, 16 μg/ml), Ser416 to Ala and Glu466 to Lys. Moxifloxacin-resistant isolates were cross-resistant to ciprofloxacin and levofloxacin, but some moxifloxacin-nonsusceptible isolates remained susceptible to gemifloxacin or nemonoxacin at 0.5 μg/ml. This study found the diversity of toxigenic and nontoxigenic strains ofC. difficilein the health care setting in Taiwan. All isolates tested were susceptible to metronidazole and vancomycin. Fidaxomicin exhibited potentin vitroactivity against all isolates tested, while the more than 10% of Taiwanese isolates with rifaximin MICs of ≥128 μg/ml raises concerns.

Enhancement of cell-mediated cytotoxicity by Clostridium difficile toxin A: An in vitro study

Toxicon ◽  
1991 ◽  
Vol 29 (4-5) ◽  
pp. 417-428 ◽  
Author(s):  
W. Malorni ◽  
S. Paradisi ◽  
M.L. Dupuis ◽  
C. Fiorentini ◽  
C. Ramoni
Keyword(s):  
Clostridium Difficile ◽  
In Vitro Study ◽  
Vitro Study ◽  
Toxin A ◽  
Clostridium Difficile Toxin ◽  
Clostridium Difficile Toxin A
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