ORAL VANCOMYCIN HYDROCHLORIDE THERAPY FOR POSTOPERATIVE METHICILLIN-CEPHEM-RESISTANT STAPHYLOCOCCUS-AUREUS ENTERITIS

The postoperative development of methicillin-cephem-resistant Staphylo coccus aureus (MRSA) enteritis can be fatal unless it is detected at a n early stage and treated with effective antibacterial agents, We repo rt herein a Japanese multicenter collaborative clinical study on the e fficacy and safety of oral vancomycin hydrochloride (VCM) in the treat ment of MRSA enteritis, A total of 49 patients who had been diagnosed as having, or were strongly suspected of having, MRSA enteritis during the early postoperative period, were given oral VCM as four standard doses of 0.5 g per day. The VCM concentrations in the blood, urine, an d feces were then measured, No side effects were observed and the clin ical efficacy of oral VCM in the 31 evaluable patients was excellent, There was a 100% clinical response rate and a 95.8% bacterial eliminat ion rate in the feces, The clinical complete response (CR) rate to ora l VCM differed significantly between patients in whom MRSA,vas detecte d only in the feces (100%) and those in whom MRSA was isolated from an additional source (57%) (P < 0.01), Although VCM concentrations in th e stools were estremely high, the levels in the blood and urine were v ery low. These results demonstrate that oral VCM should be the treatme nt of choice for postoperative MRSA enteritis due to its safety and ef ficacy.