CHLORAMPHENICOL FOR THE TREATMENT OF VANCOMYCIN-RESISTANT ENTEROCOCCAL INFECTIONS

A retrospective study of patients who received chloramphenicol for the treatment of serious vancomycin-resistant enterococcal infections bet ween 1 January 1993 and 31 August 1993 was conducted at the University of Pennsylvania Medical Center (Philadelphia), Antimicrobial suscepti bilities as well as the clinical course of infection, adverse events, and response to therapy of 16 patients were reviewed, Forty-seven perc ent of enterococcal isolates were susceptible only to chloramphenicol, tetracycline, and nitrofurantoin, Types of infection included bactere mias (n = 7), abscesses (n = 7), and others (n = 5), Of 14 patients fo r whom a clinical response could be ascertained, eight (57%) showed im provement after treatment. Of 14 patients for whom a microbiological r esponse could be ascertained, eight (73%) had sterile cultures after t reatment. No lasting adverse effect related to the drug occurred, in-h ospital mortality was 56%, but only one death could be directly attrib uted to vancomycin-resistant enterococcal infection. Chloramphenicol a ppears to be a useful and well-tolerated agent for the treatment of se rious vancomycin-resistant enterococcal infections.