Introduction: The concomitant antimicrobial properties of antineoplastic agents may play a role in causing pseudomembranous colitis, which has been documented for cisplatin, cyclophosphamide and 5-fluorouracil.Clinical Picture: We describe the first case reported in the English literature of severe pseudomembranous colitis occurring in a patient given paclitaxel as adjuvant chemotherapy for breast cancer. There was no prior antibiotic therapy. Stool culture confirmed Clostridium difficile. Treatment: Oral vancomycin, metronidazole and cholestyramine led to prompt improvement of intestinal symptoms, which resolved in two weeks. Outcome: Repeat colonoscopy performed 3 months later showed total resolution of the colitis. Conclusions: Awareness of pseudomembranous colitis after paclitaxel chemotherapy can avert life-threatening complications.
Paclitaxel was discovered in 1963 as a crude extract from the bark of the pacific yew Taxus brevifolia. Since its development, a range of anticancer activity has been demonstrated.
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