Continuous Administration of Vancomycin through a Long Intestinal Tube for <i>Clostridium difficile</i> Infection

Abstract

A 76-year-old previously healthy Japanese man experienced severe diarrhea (8,000 mL per day) after undergoing laparotomy for small bowel obstruction and was diagnosed with Clostridium difficile infection. Although he developed a maculopapular rash secondary to the systemic absorption of enteral vancomycin (VCM), the patient was successfully treated with the continuous administration of VCM through a long intestinal tube placed in the terminal ileum. This method ensured the reliable delivery of VCM to the colon, while the continuous administration maintained high fecal levels of the drug. This treatment approach is an effective minimally invasive option for patients with severe diarrhea.

A rare case of infant eosinophilia induced by oral vancomycin: a case report and literature review

“…Fortunately, except for one patient with serious underlying diseases and a poor prognosis after taking vancomycin orally for a long period of time, 25 all of the other 15 patients achieved good outcomes after stopping vancomycin and/or receiving other treatments. 11,16,19,20,23,24,27–34…”

“…26 The main clinical manifestations of IgE-mediated hypersensitivity induced by oral vancomycin are local or systemic maculopapule and urticaria. 26 Table 1 and Table 2 present a summary and analysis of the case reports (including this current case) of the adverse reactions caused by oral vancomycin, 11,16,19,20,[23][24][25][27][28][29][30][31][32][33][34] which can occur at ages ranging from 2 months to 82 years (median age, 59 years). Skin changes were the most common (13 of 16 patients; 81.3%).…”

“…Fortunately, except for one patient with serious underlying diseases and a poor prognosis after taking vancomycin orally for a long period of time, 25 all of the other 15 patients achieved good outcomes after stopping vancomycin and/or receiving other treatments. 11,16,19,20,23,24,[27][28][29][30][31][32][33][34] The effects of vancomycin on the haematological system include anaemia, leukopenia, thrombocytopenia and eosinophilia. However, there are few cases of eosinophilia caused by vancomycin in both the clinic and the published literature.…”

“…Clinical characteristics of adverse reactions related to oral vancomycin reported in 16 cases in the published literature 11,16,19,20,[23][24][25][27][28][29][30][31][32][33][34]. …”

Outcomes of Continuous Enteral Vancomycin Infusion in Intensive Care Unit Patients: A Novel Treatment Modality for Severe Clostridium Difficile Colitis

“…He was successfully treated with CEV through a long intestinal tube placed in the terminal ileum. This method ensured the reliable delivery of vancomycin to the colon [ 24 ]. In our study, we used CEV as a treatment for patients with severe CDI admitted to ICU.…”