Staphylococcal Enterocolitis—Treatment with Oral Vancomycin

Abstract

Staphylococcal enterocolitis was reported among hospital patients as a serious complication of antibiotic therapy. One hundred and 9 patients over observed with this disease during the past decade. Most of the patients received antibiotics as protection against infections during abdominal surgery. The remaining group of patients was given antibiotics either for the treatment of infections or the prevention of hepatic coma in cases of cirrhosis of the liver. Chloramphenicol, the antibiotic most often used in surgical patients, precipitated many cases of staphylococcal enterocolitis. Other antibiotics included neo-mycin, tetracycline and penicillin together with streptomycin. The diagnosis of staphylococcal enterocolitis was made on the basis of diarrhea and a smear or culture of the stool showing staphylococci in large numbers. Sensitivity tests revealed resistance of the organisms to many of the commonly used antibiotics, including neomycin and kanamycin. No resistance to vancomycin was found. Among these 109 patients, 45 were treated with oral vancomycin in a dosage of 0. 5 gm every 4 to 6 hours for 3 to 5 days. On the basis of the clinical and laboratory results obtained, oral vancomycin was the most effective and specific antibiotic for the treatment of staphylococcal enterocolitis.