Abstract

EDO PENARROCHA, J; BELLES MEDALL, MD; GARCIA MUNOZ, S  and  FERRANDO PIQUERES, R. Systemic absorption of an oral vancomycin syrup for the treatment of Clostridium difficile infection. Rev. OFIL·ILAPHAR [online]. 2021, vol.31, n.1, pp.109-111.  Epub June 07, 2021. ISSN 1699-714X.  https://dx.doi.org/10.4321/s1699-714x20210001000019.

Clostridium difficile infection (CDI) has increased its incidence in recent years, becoming one of the most common infections acquired in the hospital setting, causing an infectious diarrhea that is strongly associated with the use of antibiotics. Currently, the antibiotics used for this treatment are oral vancomycin and fidaxomycin, being oral vancomycin the most cost-effective for the National Health System.

We describe the case of a pluripatological patient who underwent two weekly hemodialysis sessions, which is diagnosed as having developed CDI to pseudomembranous colitis confirmed by endoscopy. Treatment for CDI was initiated with a master formula of oral vancomycin at a dose of 250 mg every 6 hours. Oral vancomycin therapy was not effective and safe in the patient, resulting in significant systemic absorption of vancomycin reaching plasma vancomycin concentrations of 15.57 mcg/mL. It took 8 days to complete the elimination of vancomycin, during which the patient underwent 4 hemodialysis sessions.

The described case highlights the need to monitor vancomycin plasma concentrations during the treatment of CDI, especially in patients with high doses of drug, with renal insufficiency and impairment of the integrity of the gastrointestinal tract.

Keywords : Oral vancomycin; systemic absorption; Clostridium difficile.

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