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Short-Term Benefit From Oral Vancomycin Treatment of Regressive-Onset Autism

Sections of Pediatric Gastroenterology and Nutrition, rushstudy{at}aol.com

Sydney M. Finegold, MD

Infectious Diseases Section and Research Service, University of California, Los Angeles School of Medicine, Los Angeles, CA

Ellen R. Bolte

Sections of Pediatric Gastroenterology and Nutrition

Cathleen P. Buchanan, MS

Sections of Pediatric Gastroenterology and Nutrition

Anne P. Maxwell, PhD

Pediatric Psychology, Rush Children's Hospital, Chicago, IL

Marja-Liisa Väisänen, BS

Infectious Diseases Section and Research Service, University of California, Los Angeles School of Medicine, Los Angeles, CA

Michael N. Nelson, PhD

Pediatric Psychology, Rush Children's Hospital, Chicago, IL

Hannah M. Wexler, PhD

Infectious Diseases Section and Research Service, University of California, Los Angeles School of Medicine, Los Angeles, CA

In most cases symptoms of autism begin in early infancy. However, a subset of children appears to develop normally until a clear deterioration is observed. Many parents of children with "regressive"-onset autism have noted antecedent antibiotic exposure followed by chronic diarrhea. We speculated that, in a subgroup of children, disruption of indigenous gut flora might promote colonization by one or more neurotoxin-producing bacteria, contributing, at least in part, to their autistic symptomatology. To help test this hypothesis, 11 children with regressive-onset autism were recruited for an intervention trial using a minimally absorbed oral antibiotic. Entry criteria included antecedent broad-spectrum antimicrobial exposure followed by chronic persistent diarrhea, deterioration of previously acquired skills, and then autistic features. Short-term improvement was noted using multiple pre- and post-therapy evaluations. These included coded, paired videotapes scored by a clinical psychologist blinded to treatment status; these noted improvement in 8 of 10 children studied. Unfortunately, these gains had largely waned at follow-up. Although the protocol used is not suggested as useful therapy, these results indicate that a possible gut flora-brain connection warrants further investigation, as it might lead to greater pathophysiologic insight and meaningful prevention or treatment in a subset of children with autism. (J Child Neurol 2000;15:429-435).

Journal of Child Neurology, Vol. 15, No. 7, 429-435 (2000)
DOI: 10.1177/088307380001500701


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