This retrospective observational study looked at 44 children with atypical ulcerative colitis (aUC) in Australia who received oral vancomycin (OV) therapy between 2014 – 2023. This study includes 29 children with both PSC and aUC and 15 children with aUC without PSC.

Most of the children who received OV saw reduced UC activity and fecal calprotectin, as well as achieved remission.

Here are some key point this study makes:

• Stopping OV can cause a relapse. (After stopping OV, 25 of the 44 patients relapsed within 8 months.)

• When these 25 patients started taking OV again, 13 achieved remission. So, only half responded to reintroduction.

• During a 4-year follow up, 67% of the patients were in deep remission when taking OV and conventional medical therapies.

• Routine stool testing detected no vancomycin-resistant enterococcus (VRE)!

Ultimately, this study found:

1. OV can induce remission for patients with aUC
2. Stopping OV can be risky because patients might not respond if they go back on it
3. No VRE was developed