Cholestyramine treatment of pseudomembranous colitis

Sinatra, Frank; Buntain, William L.; Mitchell, Charles H.; Sunshine, Philip

doi:10.1016/s0022-3476(76)81008-6

Cited by 22 publications

(4 citation statements)

References 6 publications

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“…Toxin binders [e.g. cholestyramine (Sinatra et al., 1976; Kreutzer and Milligan, 1978)] have been used in uncontrolled studies. Telovamer, a toxin‐binding resin, showed promise in in vitro (Hinkson et al., 2008), animal models (Hinkson et al., 2008) and early human studies (Louie et al., 2006), but more recent studies in humans have been less promising (Weiss, 2009).…”

Section: And Its Many Clinical Challengesmentioning

confidence: 99%

The Ecology and Pathobiology of Clostridium difficile Infections: An Interdisciplinary Challenge

Dubberke

Haslam

Lanzas

et al. 2010

Zoonoses and Public Health

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Summary Clostridium difficile is a well recognized pathogen of humans and animals. Although C. difficile was first identified over 70 years ago, much remains unknown in regards to the primary source of human acquisition and its pathobiology. These deficits in our knowledge have been intensified by dramatic increases in both the frequency and severity of disease in humans over the last decade. The changes in C. difficile epidemiology might be due to the emergence of a hypervirulent stain of C. difficile, aging of the population, altered risk of developing infection with newer medications, and/or increased exposure to C. difficile outside of hospitals. In recent years there have been numerous reports documenting C. difficile contamination of various foods, and reports of similarities between strains that infect animals and strains that infect humans as well. The purposes of this review are to highlight the many challenges to diagnosing, treating, and preventing C. difficile infection in humans, and to stress that collaboration between human and veterinary researchers is needed to control this pathogen.

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Section: And Its Many Clinical Challengesmentioning

confidence: 99%

The Ecology and Pathobiology of Clostridium difficile Infections: An Interdisciplinary Challenge

Dubberke

Haslam

Lanzas

et al. 2010

Zoonoses and Public Health

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“…Of the survivors, the postoperative patients who developed pseudomembranous colitis had a much more protracted illness and greater morbidity than did the patients who had not had an operation. None of the deaths was due to perforation or haemorrhage, and we now believe that many could have been avoided in the postoperative group if the diagnosis had been established and the patients given intensive supportive measures22 23 or specific treatment.24 25 Pseudomembranous colitis might have been detected in suspected cases by routine barium enema.26 But in two of the eight patients who had it, this examination exacerbated the symptoms and perforation of the colon was feared. Colonoscopy has been advocated to establish the diagnosis,27 but many of our patients were considered too ill for procedures requiring air insufflation of the colon.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of pseudomembranous colitis.

Kappas¹,

Shinagawa²,

Arabi³

et al. 1978

BMJ

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“…42 Cholestyramine was first used for pseudomembranous colitis in the late 1970 s, even prior to identification of C. difficile as the causative pathogen. 43 One early study showed successful binding of C. difficile toxin by both agents in vitro and also demonstrated efficacy of cholestyramine at delaying death in hamster models. 44 Colestipol was studied in a randomized controlled trial of 38 patients at a dose of 10 g four times daily for 5 days, but was shown to be no better than placebo with an initial cure rate of 25%.…”

Section: Ion-exchange Resinsmentioning

confidence: 99%

Use of alternative or adjuvant pharmacologic treatment strategies in the prevention and treatment of Clostridium difficile infection

Musgrave

Bookstaver

Sutton

et al. 2011

International Journal of Infectious Diseases

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Infection with Clostridium difficile is currently the leading cause of infectious diarrhea in hospitalized patients, and recent surveillance data indicate that C. difficile has surpassed methicillin-resistant Staphylococcus aureus as the number one cause of hospital-acquired infections in some areas of the USA. In addition, concern over C. difficile has increased over the past decade due to the appearance of new hypervirulent strains. Metronidazole and vancomycin have remained the treatments of choice for initial therapy of primary infection with C. difficile for the past 25 years, but the persistence of spores leads to a recurrence of infection in an estimated 20-25% of patients. Patients who have one recurrent episode have up to a 65% chance of having additional recurrence. While the judicious use of antimicrobials in accordance with antibiotic stewardship guidelines remains the most effective method for the control of C. difficile, the high recurrence rate, increasing incidence, and changing epidemiology of C. difficile has led to an increased interest in the study of alternative strategies for the prevention and treatment of C. difficile disease. These alternative strategies attempt to eliminate C. difficile spores, replenish the normal gut flora, reduce the C. difficile toxin load in the bowel, or bolster the patient's own immune response to the C. difficile toxins. To evaluate the available evidence on these alternative strategies, we conducted a literature search of MEDLINE (1966-March 2011) and International Pharmaceutical Abstracts (1970-March 2011). Available citations from these articles were also utilized. The aim of this review is to summarize the available evidence for alternative treatment strategies for C. difficile disease and to make recommendations for their place in therapy.

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Cholestyramine treatment of pseudomembranous colitis

Cited by 22 publications

References 6 publications

The Ecology and Pathobiology of Clostridium difficile Infections: An Interdisciplinary Challenge

The Ecology and Pathobiology of Clostridium difficile Infections: An Interdisciplinary Challenge

Diagnosis of pseudomembranous colitis.

Use of alternative or adjuvant pharmacologic treatment strategies in the prevention and treatment of Clostridium difficile infection

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