Recurrence of antibiotic-associated pseudomembranous colitis after parenteral metronidazole therapy and cure by oral vancomycin: case report
Meuwissen, S.G.; Rietra, P.J.; Mulder, C.J.; Reiss, M.; Visser, J.; Van Leeuwen, A.M.
Netherlands Journal of Medicine 24(1): 10-13
1981
ISSN/ISBN: 0300-2977 PMID: 7207690 Document Number: 176349
A male patient aged 65 developed a severe form of pseudomembranous colitis with abdominal distension and ileus after administration of thiamphenicol and gentamicin. Metronidazole i.v. suppressed the clinical symptoms and feces cytotoxicity titers normalized. After discontinuation symptoms recurred. Treatment with cholestyramine was ineffective; Vancomycin led to a final cure. Parenteral metronidazole seems to be effective for severely ill patients who cannot be treated orally. This observation suggests that, as soon as the clinical condition allows oral intake, oral vancomycin or metronidazole should be given additionally to eradicate toxin-producing Clostridium strains.