Journal Article

Lack of Efficacy of Oral Bacitracin Plus Doxycycline for the Eradication of Stool Colonization with Vancomycin-Resistant <i>Enterococcus faecium</i>

Mitchell R. Weinstein, Helen Dedier, James Brunton, Iivi Campbell and John M. Conly

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 29, issue 2, pages 361-366
Published in print July 1999 | ISSN: 1058-4838
Published online July 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/520216
Lack of Efficacy of Oral Bacitracin Plus Doxycycline for the Eradication of Stool Colonization with Vancomycin-Resistant Enterococcus faecium

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In a prospective observational cohort study designed to assess the role of oral bacitracin solution plus doxycycline in the eradication of intestinal carriage of vancomycin-resistant Enterococcus faecium (VREF) in patients on a renal ward, rectal swab specimens were obtained from 15 treated and 24 control patients. Cultures of the rectal swabs were negative for 15 (100%) of the antibiotic-treated vs. eight (33.3%) of the untreated patients (P < .001) on day 14. However, follow-up for a mean of 127 and 130 days revealed 9 of 15 (60%) and 15 of 24 (62.5%) in the treated and untreated cohorts (P = .86), respectively, carried VREF intermittently or persistently. Quantitative VREF stool cultures in the treated cohort revealed an initial 3.1-log10/g decrease, but there was an increase to pretreatment levels at 2–4 and 5–7 weeks post-treatment (7.8 and 7.4 log10/g). Oral bacitracin and doxycycline were not efficacious in reducing the carriage of VREF beyond the 2-week interval during which they were given.

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

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