Fekety R, Silva J, Buggy B, Deery H G
J Antimicrob Chemother. 1984 Dec;14 Suppl D:97-102. doi: 10.1093/jac/14.suppl_d.97.
Sixty-five patients were treated with oral vancomycin for Clostridium difficile colitis associated with treatment of infection by antibiotics. Colitis was confirmed by endoscopy in patients with diarrhoea and positive tests on diarrhoeal stools for Cl. difficile and/or its cytotoxin or, if endoscopy could not be performed, by the presence of fever and peripheral or faecal leucocytosis. Vancomycin dosage ranged from 125 to 500 mg four times daily for an average of about ten days. The mean duration of diarrhoea after starting therapy was four days; abdominal pain and fever usually resolved in two or three days. Post-treatment carriage of Cl. difficile was common. Eighteen per cent of patients developed a recurrence of colitis after treatment was discontinued, but responded to treatment with oral vancomycin, metronidazole, or bacitracin. After comparison of our results with those reported by others we concluded that vancomycin remains the treatment of choice for patients who are acutely and severely ill with Cl. difficile.
65例因抗生素治疗感染而并发艰难梭菌性结肠炎的患者接受了口服万古霉素治疗。对于腹泻患者，通过内镜检查以及腹泻粪便艰难梭菌和/或其细胞毒素检测呈阳性来确诊结肠炎；若无法进行内镜检查，则通过发热以及外周血或粪便白细胞增多来确诊。万古霉素剂量为每日4次，每次125至500毫克，平均约服用10天。开始治疗后腹泻的平均持续时间为4天；腹痛和发热通常在两到三天内缓解。治疗后艰难梭菌携带情况很常见。18%的患者在停药后出现结肠炎复发，但再次使用口服万古霉素、甲硝唑或杆菌肽治疗有效。将我们的结果与其他人报告的结果进行比较后，我们得出结论，万古霉素仍然是急性重症艰难梭菌感染患者的首选治疗药物。
