Intracolonic Vancomycin for Pseudomembranous Colitis

Abstract

To the Editor: We report the use of intracolonic vancomycin to treat antibiotic-associated pseudomembranous colitis in a patient with paralytic ileus. An 80-year-old man underwent combined aortocoronary-bypass grafting, thromboendarterectomy of the left carotid artery, and insertion of a Y-shaped aortoiliac graft. The initial postoperative course was uneventful. Four days after surgery, a suspected lung infection was treated with parenteral imipenem and later with ceftazidime and ciprofloxacin. Nine days after surgery, abdominal discomfort, fever, and leukocytosis (42,600 cells per cubic millimeter) developed. This was followed by paralytic ileus and two episodes of voluminous bloody diarrhea. Pseudomembranous colitis was diagnosed by colonoscopy,… © 1993, Massachusetts Medical Society. All rights reserved.