Oral Vancomycin and Gentamicin for Treatment of Very Early Onset Inflammatory Bowel Disease.
Lev-Tzion, Raffi Ledder, Oren Shteyer, Eyal TAN LI NIEN Uhlig, Holm H Turner, Dan
Lev-Tzion, Raffi
Ledder, Oren
Shteyer, Eyal
Uhlig, Holm H
Turner, Dan
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Abstract
BACKGROUND: The pathogenesis of inflammatory bowel disease (IBD) is complex and involves the contribution of genetic and environmental factors. Many patients with very early onset IBD are difficult to treat. The current antibiotic medication that targets gram-negative and anaerobic bacteria provides only moderate efficacy in subsets of patients with IBD. METHODS: We report a case series of 5 children with a mean age of 1.6 years (range 6 months to 2.7 years) during IBD onset, who were previously refractory to standard treatments and who received oral vancomycin with or without gentamicin. RESULTS: Four out of 5 children demonstrated substantial therapeutic effect, and the effect was sustained in 3 children over a follow-up period of 12-33 months. CONCLUSION: Our findings are consistent with model systems and suggest that randomized trials are required to establish whether a change in therapeutic paradigm, that is, targeting gram-positive bacteria with nonabsorbable antibiotics, may have therapeutic benefits.
Keywords
Antibiotics, Crohn disease, Primary sclerosing cholangitis, Ulcerative colitis, Administration, Oral, Age of Onset, Anti-Bacterial Agents, Child, Preschool, Drug Therapy, Combination, Female, Gentamicins, Humans, Infant, Inflammatory Bowel Diseases, Male, Vancomycin
Source Title
Digestion
Publisher
S. Karger AG
Series/Report No.
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Date
2017
DOI
10.1159/000475660
Type
Article