The search for a better treatment for recurrent Clostridium difficile disease: Use of high-dose vancomycin combined with Saccharomyces boulardii

Christina M. Surawicz, Lynne V. McFarland, Lynne V. McFarland, Richard N. Greenberg, Moshe Rubin, Robert Fekety, Maury E. Mulligan, Reuben J. Garcia, Sally Brandmarker, Karen Bowen, Delia Borjal, Gary W. Elmer

Research output: Contribution to journalArticlepeer-review

500 Scopus citations

Abstract

Recurrent Clostridium difficile disease (CDD) is a difficult clinical problem because antibiotic therapy often does not prevent further recurrences. In a previous study, the biotherapeutic agent Saccharomyces boulardii was used in combination with standard antibiotics and was found to be effective in reducing subsequent recurrences of CDD. In an effort to further refine a standard regimen, we tested patients receiving a regimen of a standard antibiotic for 10 days and then added either S. boulardii (1 g/day for 28 days) or placebo. A significant decrease in recurrences was observed only in patients treated with high-dose vancomycin (2 g/day) and S. boulardii (16.7%), compared with those who received high-dose vancomycin and placebo (50%; P = .05). No serious adverse reactions were observed in these patients. Comparison of data from this trial with data from previous studies indicates that recurrent CDD may respond to a short course of high-dose vancomycin or to longer courses of low-dose vancomycin when either is combined with S. boulardii.

Original languageEnglish
Pages (from-to)1012-1017
Number of pages6
JournalClinical Infectious Diseases
Volume31
Issue number4
DOIs
StatePublished - 2000

Bibliographical note

Funding Information:
Grant support: Support was received from a grant (PMC Relapse) from Laboratoires Biocodex (Montrouge, France).

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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