Colitis causing

Vancomycin (Vancocin) acts against susceptible gram-positive bacteria by inhibiting bacterial cell wall synthesis and increasing cell wall permeability. This drug is used in the treatment of serious gram-positive infections that do not respond to treatment with other anti-infectives. It also may be used in treating anti-infective-associated pseudomembranous colitis caused by Clostridium difficile. 

Surawicz CM, McFarland LV Pseudomembranous colitis Causes and cures. Digestion 1999 60 91-100. 

Staphylococcal enterocolitis, ID-antibacterial-associated pseudomembranous colitis caused by Clostridium difficile PO 0.5-2 g/day in 3-4 divided doses for 7-10 days. Dosage in renal impairment After a loading dose, subsequent dosages and frequency are modified based on creatinine clearance, the severity of the infection, and the serum concentration of the drug. 

Ravi, S., Keat, A.C., Keat, E.C. Colitis caused by non-steroidal anti-inflammatory drugs, Postgrad. Med. 

Budesonide for collagenous colitis caused Cushing s syndrome in a patient with chronic renal insufficiency taking amiodarone for paroxysmal atrial fibrillation (477). 

Because of its potential toxicity, vancomycin is reserved for serious infections in which less toxic antibiotics are ineffective or not tolerated. Generally, vancomycin is administered intravenously because of poor intestinal absorption. It is the drug of choice for treating infections caused by methicillin-resistant staphylococci and penicillin-resistant Streptococcus pneumoniae. Vancomycin has been used to treat enterococcal infections because of their resistance to the P-lactam antibiotics, but most enterococci are now also resistant to vancomycin. Oral administration of rancomycin is important for treatment of some gastrointestinal infections such as pseudomembranous colitis caused by C. difficile. 

Antibiotic-associated pseudomembraneous colitis (caused by Clostridium difficile)... 

Parry MF, Rha CK. Pseudomembranous colitis caused by topical clindamycin phosphate. Arch Dermatol 1986 122(5) 583-4. 

During the past decade an increasing incidence of C. difficile disease has been evident worldwide. This bacterium is now recognized as a major nosocomial pathogen in industrialized parts of the world (Lyerly and Wilkins, 1995). The pseudomembranous colitis caused by C. difficile was early recognized as a toxin disease, i.e., all symptoms can be evoked by the toxins. Understanding the disease thus requires an understanding of the toxins. 

The reported incidence of diarrhea associated with the administration of clindamycin ranges from 2 to 20%. A number of patients (variously reported as 0.01 to 10%) have developed pseudomembranous colitis caused by the toxin from the organism C. difficile. This colitis is characterized by abdominal pain, diarrhea, fever, and mucus and blood in the stools. Proctoscopic examination reveals white-to-yellow... 

Gastrointestinal Ah tetracychnes can produce GI irritation, typically after oral administration. Tolerabihty can be improved by administering the drug with food, but tetracyclines should not be taken with dairy products or antacids. Tetracychne has been associated with esophagitis and pancreatihs. Pseudomembranous colitis caused by overgrowth of C. difficile is a potentially life-threatening complication. 

Vancomycin is bactericidal. It acts at an early stage in cell wall synthesis and does not bind to PBPs. It is not absorbed following oral administration and is used by this route in the treatment of colitis caused by Clostridium difficile and staphylococci. Vancomycin is not susceptible to beta-lactamases since it is not a beta-lactam. Vancomycin continues to have useful activity against strains of methicillin-resistant staphylococci. The answer is (C). 

When given orally, vancomycin has been effective in the treatment of colitis caused by toxin-producing bacteria, including C difficile. However, most infectious disease specialists advocate treatment of pseudomembranous colitis with metronidazole. Oral metronidazole is equally effective, and the cost of treatment is only one-third that of vancomycin. Most importantly, because of the increasing incidence of vancomycin-resistant enterococci and staphylococci, this drug should not be used if an alternative agent is readily available. 

Traino AA, Buckley Bassett ML. Probable ischemic colitis caused by pseudoephedrine with tramadol as a possible contributing factor. Ann Pharmacoiher (2004) 38,2068-70. 

Conedera, G., Mattiazzi, E., Russo, R, Chiesa, E., Scorzato, L, Grandesso, S., et al. (2007). A family outbreak of Escherichia coli 0157 haemorrhagic colitis caused by pork meat salami. Epidemiology and Infection, 135, 311-314. 

Hoffmann KM, Deutschmann A, Weitzer C, Joainig M, Zechner E, Hogenauer C, Hauer AC. Antibiotic-associated hemorrhagic colitis caused by cytotoxin-producing Klebsiella oxytoca. Pediatrics 2010 125(4) e960-3. 

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