Summary: Autism remains one of the enigmas of diagnosis and management. Theories of causation, pathology and remedies are thicker than flies. But, still we keep searching for the answer. This one concerns use of a very potent antibiotic to alter gut bacterial populations to decrease productions of some alleged neurotoxins that cause or aggravate autistic behavior, though for a short time only. Last revised January 21, 2007



Vancomycin is a distinct class of antiobiotics unrelated to the family of penicillins, streptomycin, cephalosporins, quinolones, sulfonamides, erythromycin, etc. that we use routinely in medical practice. Its use in medicine is reserved for the treatment of multi-drug resistant Staphylococcal infections that are life threatening. It is a toxic drug and its usage is best left to medical specialists.


What is autism and what causes it? We wish we knew more.
There are many useful bacteria in our gut that, by competition for food, inhibit the growth of many harmful bacteria in our gut. The extensive use of broad spectrum antibiotic therapy kills these normal and useful bacteria, and allow overgrowth of harmful intestinal infection, a condition called Super-Infection. Some of these harmful bacteria, so goes the theory, can produce nerve-killing toxins that enter the brain of a susceptible autistic child, to trigger, cause or aggravate autistic behavior. Oral Vancomycin could kill that infection, without being absorbed into systemic circulation (hence unlikely to cause immediate harm to the child).
A lady in Illinois had an autistic child. The child screamed for hours. He even chewed drywall from the walls. Complicating matters were severe diarrhea and other gastrointestinal problems. He had had recurrent ear infections, for which antibiotics were prescribed shortly before he became autistic at 19 months. Based on her extensive studies in medical libraries, the mother theorized those drugs killed Andrew's normal gut-protective bacteria and allowed an intestinal infection that can produce nerve-killing toxins to enter his brain. Vancomycin, she thought, could kill that infection.
Based on that hope, she managed to persuade a scientist to try oral vancomycin in her child to see if it might help her son's severe autism. To their surprise, the child got better. He was not cured, but all of a sudden he started saying words and became toilet-trained. The scientists were intrigued as that was not expected to happen.
So the treatment was extended to eleven more autistic children who, like about a third of children with this serious brain disorder, also suffer painful gastrointestinal problems. Neuropsychological testing concluded that 10 children improved, though only for a while.
All the children worsened after just a few months. However, a little bit of the improvement remained, making it a little easier to manage them, though the remnant improvement was variable.

Dr. Michael Chez of Chicago plans to compare vancomycin to a dummy drug in a "Placebo controlled study" to find out if the improvements are genuine or merely the result of increased attention and care given to the children during the trial.
Scientists are trying to study whether there is a cause and effect association between gut bacterial problems and brain function. At present, intense behavior therapy is autism's only proven treatment. The famous secretin therapy of autism already seems to be falling by the wayside. Some other nutritional aids and vitamins provide some help though they are not curative. Will vancomycin or an allied antibiotic hold a future therapeutic key ? Only more research will answer the question.

About vancomycin

Vancomycin is a macrolide glycopeptide class of antibiotic. It interacts with many drugs and may cause kidney, hearing, or balance dysfunction. Its adverse effects also include the following: skin rash, red neck, flushing, drug fever, low white blood cell count, increased eosinophil count in blood, allergic shock, low blood pressure, wheezing, and skin eruptions. Most of these reactions are seen only during injectable treatment.

Vancomycin is one of our main-stays against multi-drug resistant life threatening infection with Staphylococcus aureas or antibiotic induced large gut infection. If it is misused by indiscriminate oral therapy as above, then the bacteria may become resistant to vancomycin also, and we will have lost another important battle against drug resistant bacteria.

This is why doctors are still hesitant to prescribe vancomycin for autism till we have more conclusive data.


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