Table 4 Large case series reporting Clostridium difficile infections (CDI) treated with intracolonic vancomycin per rectum

Current Series

26 patients over 10 years: 2003 - 2012

Single VA center, Loma Linda, CA

Median age = 69 years

Severity Score Index (range 0–9) = 5.2 suggestive of “moderate” CDI

Mean WBC = 27 k

16 patients survived, 10 died

Variable doses ranging from 0.25g q24 h to 1g q6h – most common dose 500 mg q6h

Saffouri

Gastroenterology 2014 [11]

17 patients over 7 years: 2005–2012.

Single tertiary care teaching hospital, Rochester, MN

Median age = 70 years

“Severe” CDI (WBC > 15 k or serum creatinine >1.5x baseline) or “Severe-complicated” CDI (i.e., shock, hypotension, ileus., toxic megacolon or ICU admission)

16 patients survived, 1 died

Variable doses ranging from 0.25g q6 to 1g q6 – most common dose 500 mg q6h

Kim

Surg Infect 2013 [10]

47 patients over 2.75 years: 2007 - 2009

Single inner-city hospital, Bronx, NY

Mean age = 65 years

“Severe” CDI (any of the following: WBC > 15 k, abdominal tenderness, acidosis)

Mean WBC = 27 k

37 patients survived, 10 died

All received 1 g q6h

Apiusarnthanarkak

CID 2002 [6]

9 cases over 3 years over 3.5 years: 1998 - 2001

Single tertiary care teaching hospital, St. Louis, MO

Median age = 65 years

Mean APACHE II score = 18 (range 12–26)

Median WBC = 24 k

8 patients survived, 1 died

Variable doses ranging from 0.5g q4h to 1 g q12h – most common dose 1g q12h

Shetler

Surg Endosc 2001 [9]

8 cases

Single VA center, Palo Alto, CA

Mean age = 70 years

“Severe” CDI all with ileus and toxic megacolon

Median WBC = 24 k

3 patients survived, 4 died

All received 0.25g q6h