Review article: the evidence that vancomycin is a therapeutic option for primary sclerosing cholangitis

J. L. Damman, E. A. Rodriguez, A. H. Ali, C. W. Buness, K. L. Cox, E. J. Carey, Keith Lindor

Research output: Contribution to journalReview articlepeer-review

57 Scopus citations


Background and Aims: PSC is an autoimmune biliary inflammatory disorder that is often associated with inflammatory bowel disease (IBD), with 50%-75% of patients with PSC having coexisting IBD, most commonly ulcerative colitis. Currently, no medical therapies have been shown to improve the disease course or slow its progression. However, ongoing research has resulted in a growing interest in the use of antibiotics for treatment of PSC, of which vancomycin is the most studied. In this review, we summarise the current evidence on the use of vancomycin in PSC and comment on future research areas of interest. Methods: A comprehensive PUBMED and EMBASE literature search for articles on vancomycin, PSC, therapeutic options and microbiome was performed. Results: Two randomised clinical trials, three case series and two case reports were included in the study. These include uncontrolled data from at least 98 patients that include promising improvements in biochemistry and imaging. Optimal dosing regimens are unclear. Conclusion: Vancomycin is one of the most studied antibiotics used in the treatment of PSC with promising results. There is not currently sufficient evidence to support treatment recommendations. Further research is needed to establish if vancomycin is a PSC treatment.

Original languageEnglish (US)
Pages (from-to)886-895
Number of pages10
JournalAlimentary Pharmacology and Therapeutics
Issue number7
StatePublished - Apr 2018

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology
  • Pharmacology (medical)


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