Evaluation of an Oral Vancomycin Capsule for the Treatment of Clostridioides difficile Infections in an Academic Medical Center in Thailand

Abstract

Background: The oral capsule formulation of vancomycin (Vancin-S) recently became available in Thailand; therefore, information on its effectiveness and safety in treating Clostridioides difficile infection (CDI) has not been available. Objective: To evaluate CDI outcomes and to access safety at the HRH Princess Maha Chakri Sirindhorn Medical Center (MSMC) following recommended oral vancomycin capsule treatment. Materials and Methods: Retrospective review of MSMC patients prescribed oral vancomycin capsule between December 1, 2022 and August 31, 2023. Inclusion and exclusion criteria were applied, analyzing CDI outcomes post- oral vancomycin capsule treatment and within 90 days thereafter. Safety of oral vancomycin capsule usage was also assessed. Results: Of the 41 patients prescribed oral vancomycin capsule, 13 met inclusion criteria and did not meet with exclusion criteria. There were eight definite and five probable CDI cases, with 12 initial treatments and one initial fulminant treatment. The incidence of CDI in the MSMC was 21.33 person-year. Clinical improvements were observed by the tenth day, with one patient experiencing residual symptoms, subsequently testing negative for CDI. All patients were cured. The oral vancomycin capsule treatments were well-tolerated without significant adverse effects. No CDI recurrence was detected among 12 cases followed up within 90 days post-treatment. Conclusion: The oral vancomycin capsule demonstrates safety and potential efficacy for CDI treatment in Thailand. Keywords: Oral vancomycin; Clostridioides difficile infection; Thailand