Journal Article

The Search for a Better Treatment for Recurrent <i>Clostridium difficile</i> Disease: Use of High-Dose Vancomycin Combined with <i>Saccharomyces boulardii</i>

Christina M. Surawicz, Lynne V. McFarland, Richard N. Greenberg, Moshe Rubin, Robert Fekety, Maury E. Mulligan, Reuben J. Garcia, Sally Brandmarker, Karen Bowen, Delia Borjal and Gary W. Elmer

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 31, issue 4, pages 1012-1017
Published in print October 2000 | ISSN: 1058-4838
Published online October 2000 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/318130
The Search for a Better Treatment for Recurrent Clostridium difficile Disease: Use of High-Dose Vancomycin Combined with Saccharomyces boulardii

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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.

Journal Article.  3959 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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