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The Search for a Better Treatment for Recurrent Clostridium difficile Disease: Use of High-Dose Vancomycin Combined with Saccharomyces boulardii
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The Search for a Better Treatment for Recurrent Clostridium difficile Disease: Use of High-Dose Vancomycin Combined with Saccharomyces boulardii
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Journal Article
The Search for a Better Treatment for Recurrent Clostridium difficile Disease: Use of High-Dose Vancomycin Combined with Saccharomyces boulardii
2000
Overview
Recurrent Clostridium difficile disease (CDD) is a difficult clinical problem because antibiotic therapy often does not prevent further recurrences. In a previous study, the biotherapeutic agent Saccharomyces boulardii was used in combination with standard antibiotics and was found to be effective in reducing subsequent recurrences of CDD. In an effort to further refine a standard regimen, we tested patients receiving a regimen of a standard antibiotic for 10 days and then added either S. boulardii (1 g/day for 28 days) or placebo. A significant decrease in recurrences was observed only in patients treated with high-dose vancomycin (2 g/day) and S. boulardii (16.7%), compared with those who received high-dose vancomycin and placebo (50%; P = .05). No serious adverse reactions were observed in these patients. Comparison of data from this trial with data from previous studies indicates that recurrent CDD may respond to a short course of high-dose vancomycin or to longer courses of low-dose vancomycin when either is combined with S. boulardii.
Publisher
The University of Chicago Press,University of Chicago Press
Subject
/ Anti-Bacterial Agents - administration & dosage
/ Bacterial diseases of the digestive system and abdomen
/ Biological and medical sciences
/ Clostridium difficile - drug effects
/ Clostridium difficile - isolation & purification
/ Colitis
/ Diarrhea
/ Dosage
/ Enterocolitis, Pseudomembranous - drug therapy
/ Enterocolitis, Pseudomembranous - microbiology
/ Enterocolitis, Pseudomembranous - therapy
/ Female
/ Humans
/ Male
/ Placebos
/ Probiotics - therapeutic use
/ Relapse
/ Toxins
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