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Direct instillation via colonic retention enema, colonoscopy, or long rectal tube has been shown to be an effective strategy in smaller series reports (70,71). For this approach, vancomycin 500 mg in a volume of at least optionsscheine finden onvista ml four times per day is recommended.

Again, a higher dosing strategy is utilized and it is given in a greater volume than that previously recommended based upon the hypothesis that larger volumes increase the likelihood that the drug will be delivered to the more proximal aspect of the colon; a volume of at least 500 ml is believed to ensure delivery to the ascending and transverse colon. If saline is being used as a carrier for vancomycin enemas, serum electrolytes should be closely monitored optionsscheine finden onvista of optionsscheine finden onvista colonic electrolyte absorption and subsequent electrolyte abnormalities, most notably hyperchloremia.

If hyperchloremia occurs, a carrier with a lower concentration of chloride (e.

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