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Oral vancomycin hydrochloride therapy for postoperative methicillin-cephem-resistantStaphylococcus aureus enteritis

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An Erratum to this article was published on 01 January 1998

Abstract

The postoperative development of methicillincephem-resistantStaphylococcus aureus (MRSA) enteritis can be fatal unless it is detected at an early stage and treated with effective antibacterial agents. We report herein a Japanese multicenter collaborative clinical study on the efficacy and safety of oral vancomycin hydrochloride (VCM) in the treatment 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 0.5g per day. The VCM concentrations in the blood, urine, and feces were then measured. No side effects were observed and the clinical efficacy of oral VCM in the 31 evaluable patients was excellent. There was a 100% clinical response rate and a 95.8% bacterial elimination rate in the feces. The clinical complete response (CR) rate to oral VCM differed significantly between patients in whom MRSA was detected only in the feces (100%) and those in whom MRSA was isolated from an additional source (57%) (P<0.01). Although VCM concentrations in the stools were extremely high, the levels in the blood and urine were very low. These results demonstrate that oral VCM should be the treatment of choice for postoperative MRSA enteritis due to its safety and efficacy.

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Authors and Affiliations

  1. Second Department of Surgery, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113, Tokyo, Japan

    Toshiro Konishi

  2. Department of Surgery, Second Division, Saitama Medical Center, Saitama Medical School, 1981 Tsujido-machi, Komada, 350, Kawagoe-shi, Saitama, Japan

    Yasuo Idezuki

  3. Infection Control and Prevention Service, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113, Tokyo, Japan

    Hiroyoshi Kobayashi

  4. Tokyo Senbai Hospital, 1-4-3 Mita, Minato-ku, 108, Tokyo, Japan

    Kaoru Shimada

  5. Third Department of Surgery, Nihon University School of Medicine, 30-1 Kami-machi, Oyaguchi, Itabashi-ku, 173, Tokyo, Japan

    Shigetomi Iwai

  6. Department of Microbiology, Toho University School of Medicine, 5-21-16 Ohmori-nishi, Ohta-ku, 143, Tokyo, Japan

    Keizo Yamaguchi

  7. Department of Surgery, Nagoya-shi Koseiin Geriatric Hospital, 2-1501 Sekubo, Meito-ku, 465, Nagoya, Japan

    Nagao Shinagawa

Authors
  1. Toshiro Konishi
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  2. Yasuo Idezuki
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  3. Hiroyoshi Kobayashi
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  4. Kaoru Shimada
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  5. Shigetomi Iwai
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  6. Keizo Yamaguchi
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  7. Nagao Shinagawa
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Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/BF02483627.

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Konishi, T., Idezuki, Y., Kobayashi, H. et al. Oral vancomycin hydrochloride therapy for postoperative methicillin-cephem-resistantStaphylococcus aureus enteritis. Surg Today 27, 826–832 (1997). https://doi.org/10.1007/BF02385273

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  • DOI: https://doi.org/10.1007/BF02385273

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