Buggy B P, Fekety R, Silva J
J Clin Gastroenterol. 1987 Apr;9(2):155-9. doi: 10.1097/00004836-198704000-00009.
Seven patients with multiple bacteriologic and symptomatic relapses of Clostridium difficile-associated diarrhea and/or colitis were treated with vancomycin and rifampin in combination. Diarrhea and abdominal pain promptly resolved in all, and neither C. difficile nor its toxin could be recovered from their stools shortly after therapy. However, stools of all patients subsequently became culture-positive for C. difficile and occasionally had demonstrable cytotoxin. Except in one instance following oral antibiotic use, all patients remained free of symptoms. Resistance to either vancomycin or rifampin was not encountered. Biotyping of isolates with clostridial bacteriophages and bacteriocins suggested true relapse with the same organism in all patients studied, rather than reinfection with another strain. Vancomycin and rifampin in combination appear to be useful in the therapy of relapsing antibiotic-associated diarrhea due to C. difficile.
七名患有艰难梭菌相关性腹泻和/或结肠炎且多次出现细菌学和症状性复发的患者接受了万古霉素和利福平联合治疗。所有患者的腹泻和腹痛均迅速缓解，治疗后不久其粪便中均未检出艰难梭菌及其毒素。然而，所有患者的粪便随后均再次培养出艰难梭菌阳性，且偶尔可检测到细胞毒素。除一例在口服抗生素后出现复发外，所有患者均无症状。未发现对万古霉素或利福平耐药的情况。用梭菌噬菌体和细菌素对分离株进行生物分型表明，在所有研究的患者中均为同一菌株真正复发，而非再次感染另一菌株。万古霉素和利福平联合使用似乎对治疗艰难梭菌引起的复发性抗生素相关性腹泻有用。
