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Vancomycin Therapy Has Only Short-Term Benefit for Patients With Autism

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By Reinberg

WESTPORT, Jul 19 (Reuters Health) - Vancomycin administration to children

with regressive-onset autism produces only short-term improvement in

symptoms, according to a report in the July issue of the Journal of Child

Neurology.

Noting that some patients with regressive-onset autism had undergone repeated

broad-spectrum antimicrobial therapy, usually for chronic otitis media,

before developing autism, the researchers hypothesized that antibiotics had

disrupted indigenous intestinal organisms, allowing colonization of

neurotoxin-producing species.

To test their hypothesis, Dr. H. Sandler from Rush Children's

Hospital, Chicago, Illinois, and a multicenter team recruited 11 children

with regressive-onset autism who had a history of antimicrobial therapy. The

children were given vancomycin 500 mg per day for 8 weeks.

Based on Wilcoxon Signed Rank Z-scores and other measures, during treatment

with vancomycin, Dr. Sandler's group noted improvement in communication and

behavior for the group as a whole. " Although improvement was clear by several

measures, unfortunately these gains did not endure, " they say.

When the parents of the children were telephoned 2 weeks after the end of the

trial, most reported " substantial behavioral deterioration. " When the

children were seen after 2 to 8 months, all but one had returned to baseline

analog ratings.

" We treated several kids after the trial for a longer period and they

relapsed as well, " Dr. Sandler told Reuters Health. " My hypothesis is, " he

said, " that there is a bug that is very tough to treat and that the medicine

that we are using was only partially suppressing it. "

Dr. Sandler and associates say in the journal that the " results of this

preliminary study, along with previous reports of increased intestinal

permeability and a 'nonspecific colitis' in children with autism, suggests a

possible 'gut-brain' etiologic connection in a subset of these children. " The

current conventional genetic model of autism, they note, cannot explain their

findings.

The team cautions that " the potential threat of vancomycin-resistant

organisms must be seriously considered. " They urge, therefore, " that

vancomycin not be used to treat autistic symptomatology outside of a study

protocol. "

" We have raised an intriguing possibility of an avenue to explore in an area

in which there is so little or nothing currently offered, " Dr. Sandler noted.

" To have intriguing bits of information about a possible connection that

could lead to effective treatment at least in a subset of kids is, I think,

worthy of attention. "

J Child Neurol 2000;15:429-435.

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