This case report shares that a 23-year old female has been taking vancomycin for PSC for eight years, and achieved normalization of liver enzymes and resolution of UC symptoms with colonic mucosal healing. There has been no colon dysplasia, liver fibrosis or failure, bile duct stricture, or cancer.

However, the patient experienced worsening symptoms when insurance switched her vancomycin brand to Akorn, Alvogen, and generic brands from the ANI Pharmaceuticals brand in which she had normal stools and liver biochemistries. Her symptoms also varied with different doses.

This suggests that vancomycin’s success in PSC may be brand and dose dependent, and some brands may provide better outcomes for patients.