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. 1985 Dec;26(12):1380–1384. doi: 10.1136/gut.26.12.1380

Double blind controlled trial of oral vancomycin as adjunctive treatment in acute exacerbations of idiopathic colitis.

R J Dickinson, H J O'Connor, I Pinder, I Hamilton, D Johnston, A T Axon
PMCID: PMC1433117  PMID: 3910524

Abstract

A prospective double blind trial of vancomycin vs placebo was undertaken in 40 consecutive adult patients with exacerbation of idiopathic colitis (33 ulcerative colitis, seven Crohn's disease). Vancomycin or placebo (500 mg six hourly) was given for seven days in addition to routine medical therapy. Although there was no significant overall difference in outcome between the two groups, there was a trend towards a reduction in the need for operative intervention in patients with ulcerative colitis treated with vancomycin compared with controls. The efficacy of vancomycin was not attributable to its known action against C difficile, which was not isolated from any of the patients. The data suggest that microbiological factors may play a part in the pathogenesis of ulcerative colitis and that further studies using antimicrobials are desirable.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bartlett J. G. Clostridium difficile and inflammatory bowel disease. Gastroenterology. 1981 Apr;80(4):863–865. [PubMed] [Google Scholar]
  2. Bolton R. P., Sherriff R. J., Read A. E. Clostridium difficile associated diarrhoea: a role in inflammatory bowel disease? Lancet. 1980 Feb 23;1(8165):383–384. doi: 10.1016/s0140-6736(80)90940-x. [DOI] [PubMed] [Google Scholar]
  3. Cooke E. M. A quantitative comparison of the faecal flora of patients with ulcerative colitis and that of normal persons. J Pathol Bacteriol. 1967 Oct;94(2):439–444. doi: 10.1002/path.1700940225. [DOI] [PubMed] [Google Scholar]
  4. DICK A. P., GRAYSON M. J., CARPENTER R. G., PETRIE A. CONTROLLED TRIAL OF SULPHASALAZINE IN THE TREATMENT OF ULCERATIVE COLITIS. Gut. 1964 Oct;5:437–442. doi: 10.1136/gut.5.5.437. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Dickinson R. J., Dixon M. F., Axon A. T. Staphylococcal enterocolitis and inflammatory bowel disease. J Clin Pathol. 1980 Jun;33(6):604–605. doi: 10.1136/jcp.33.6.604-b. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Driscoll R. H., Jr, Rosenberg I. H. Total parenteral nutrition in inflammatory bowel disease. Med Clin North Am. 1978 Jan;62(1):185–201. doi: 10.1016/s0025-7125(16)31831-4. [DOI] [PubMed] [Google Scholar]
  7. George R. H. A micro-method for detecting toxins in pseudomembranous colitis. J Clin Pathol. 1979 Mar;32(3):303–304. doi: 10.1136/jcp.32.3.303. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Greenfield C., Burroughs A., Szawathowski M., Bass N., Noone P., Pounder R. Is pseudomembranous colitis infectious? Lancet. 1981 Feb 14;1(8216):371–372. doi: 10.1016/s0140-6736(81)91683-4. [DOI] [PubMed] [Google Scholar]
  9. Hafiz S., Oakley C. L. Clostridium difficile: isolation and characteristics. J Med Microbiol. 1976 May;9(2):129–136. doi: 10.1099/00222615-9-2-129. [DOI] [PubMed] [Google Scholar]
  10. Keighley M. R. Antibiotic-associated pseudomembranous colitis: pathogenesis and management. Drugs. 1980 Jul;20(1):49–56. doi: 10.2165/00003495-198020010-00003. [DOI] [PubMed] [Google Scholar]
  11. Keighley M. R., Burdon D. W., Arabi Y., Williams J. A., Thompson H., Youngs D., Johnson M., Bentley S., George R. H., Mogg G. A. Randomised controlled trial of vancomycin for pseudomembranous colitis and postoperative diarrhoea. Br Med J. 1978 Dec 16;2(6153):1667–1669. doi: 10.1136/bmj.2.6153.1667. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Khan M. Y., Hall W. H. Staphylococcal enterocolitis--treatment with oral vancomycin. Ann Intern Med. 1966 Jul;65(1):1–8. doi: 10.7326/0003-4819-65-1-1. [DOI] [PubMed] [Google Scholar]
  13. LaMont J. T., Trnka Y. M. Therapeutic implications of Clostridium difficile toxin during relapse of chronic inflammatory bowel disease. Lancet. 1980 Feb 23;1(8165):381–383. doi: 10.1016/s0140-6736(80)90939-3. [DOI] [PubMed] [Google Scholar]
  14. Lennard-Jones J. E., Lockhart-Mummery H. E., Morson B. C. Clinical and pathological differentiation of Crohn's disease and proctocolitis. Gastroenterology. 1968 Jun;54(6):1162–1170. [PubMed] [Google Scholar]
  15. Meyers S., Mayer L., Bottone E., Desmond E., Janowitz H. D. Occurrence of Clostridium difficile toxin during the course of inflammatory bowel disease. Gastroenterology. 1981 Apr;80(4):697–670. [PubMed] [Google Scholar]
  16. SENECA H., HENDERSON E. Normal intestinal bacteria in ulcerative colitis. Gastroenterology. 1950 May;15(1 1):34–39. [PubMed] [Google Scholar]
  17. Simon G. L., Gorbach S. L. Intestinal flora in health and disease. Gastroenterology. 1984 Jan;86(1):174–193. [PubMed] [Google Scholar]
  18. TRUELOVE S. C., WATKINSON G., DRAPER G. Comparison of corticosteroid and sulphasalazine therapy in ulcerative colitis. Br Med J. 1962 Dec 29;2(5321):1708–1711. doi: 10.1136/bmj.2.5321.1708. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. TRUELOVE S. C., WITTS L. J. Cortisone in ulcerative colitis; final report on a therapeutic trial. Br Med J. 1955 Oct 29;2(4947):1041–1048. doi: 10.1136/bmj.2.4947.1041. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Teasley D. G., Gerding D. N., Olson M. M., Peterson L. R., Gebhard R. L., Schwartz M. J., Lee J. T., Jr Prospective randomised trial of metronidazole versus vancomycin for Clostridium-difficile-associated diarrhoea and colitis. Lancet. 1983 Nov 5;2(8358):1043–1046. doi: 10.1016/s0140-6736(83)91036-x. [DOI] [PubMed] [Google Scholar]
  21. Trnka Y. M., LaMont J. T. Association of Clostridium difficile toxin with symptomatic relapse of chronic inflammatory bowel disease. Gastroenterology. 1981 Apr;80(4):693–696. [PubMed] [Google Scholar]
  22. Truelove S. C., Willoughby C. P., Lee E. G., Kettlewell M. G. Further experience in the treatment of severe attacks of ulcerative colitis. Lancet. 1978 Nov 18;2(8099):1086–1088. doi: 10.1016/s0140-6736(78)91816-0. [DOI] [PubMed] [Google Scholar]
  23. van der Wiel-Korstanje J. A., Winkler K. C. The faecal flora in ulcerative colitis. J Med Microbiol. 1975 Nov;8(4):491–501. doi: 10.1099/00222615-8-4-491. [DOI] [PubMed] [Google Scholar]

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