Bartlett J G, Tedesco F J, Shull S, Lowe B, Chang T
Gastroenterology. 1980 Mar;78(3):431-4.
Twenty patients with antimicrobiol-associated diarrhea had a symptomatic relapse after oral vancomycin therapy. All patients had stool examinations which implicated C. difficile as the causative agent, and 16 had pseudomembranous colitis. Clinical courses were characterized by resolution of symptoms with recurrence of diarrhea at 4--21 days after vancomycin was discontinued. Studies of stools collected sequentially showed that vancomycin failed to eliminate C. difficile despite susceptibility to this agent with in vitro testing. A review of our records shows the incidence os symptomatic relapse is approximately 14%. This experience emphasizes the importance of adequate follow-up in patients treated with oral vancomycin for antibiotic-associated diarrhea or colitis due to C. difficile.
20例患有抗生素相关性腹泻的患者在口服万古霉素治疗后出现症状复发。所有患者均进行了粪便检查，结果表明艰难梭菌是病原体，其中16例患有假膜性结肠炎。临床病程的特点是在停用万古霉素后4 - 21天症状缓解，但腹泻复发。对连续收集的粪便进行研究表明，尽管体外试验显示艰难梭菌对万古霉素敏感，但万古霉素未能清除该菌。回顾我们的记录发现，症状复发的发生率约为14%。这一经验强调了对因艰难梭菌引起的抗生素相关性腹泻或结肠炎而接受口服万古霉素治疗的患者进行充分随访的重要性。
