Vancomycin for Primary Sclerosing Cholangitis

Exclusion Criteria

• •1. Administration of an antibiotic within 3 months prior to the study,
• •2. Pregnancy or attempting to become pregnant or breastfeeding,
• •3. Presence of any of the following:
• •i. Hepatitis B infection
• •ii. Hepatitis C infection (antibody positive); patients with a history of hepatitis C infection will be eligible for this study if they have undetectable levels of HCV RNA
• •iii. Other cholestatic liver diseases such as primary biliary cholangitis and cholestatic diseases of pregnancy
• •iv. Metabolic liver diseases such as Wilson's disease and hemochromatosis
• •v. Inherited diseases of the liver such as α-1 antitrypsin deficiency
• •vi. Immunoglobulin G4-related cholangitis
• •vii. PSC with concomitant autoimmune hepatitis (AIH) and/or primary biliary cholangitis (previously known as primary biliary cirrhosis)
• •viii. Secondary sclerosing cholangitis (SSC),
• •ix. Active acute ascending cholangitis requiring antibiotics
• •x. CCA (malignant biliary stricture, neoplasm, and cytology/histopathology or positive fluorescence in situ hybridization (FISH) consistent with adenocarcinoma of the bile duct)
• •xi. A liver biopsy, if one has been previously obtained, which showed non-alcoholic steatohepatitis (NASH). Patients with suspected fatty liver by imaging will not be excluded
• •xii. Presence of decompensated cirrhosis such as hepatic encephalopathy, hepato-renal syndrome and hepato-pulmonary syndrome,
• •xiii. History of liver transplantation, anticipated need for liver transplantation within 12 months from randomization, or a Model of End Stage Liver Disease (MELD) score of ≥15
• •xiv. Ongoing alcohol abuse (\>4 drinks per day for men, and \>2 drinks per day for women)
• •xv. History of allergic reaction to vancomycin,
• •xvi. Moderate-to-severe renal impairment with a calculated creatinine clearance of \< 60mL/min
• •xvii. HIV/AIDS,
• •xviii. Any other conditions or abnormalities that, in the opinion of the investigator, may compromise the safety of the subject or interfere with the subject participating in or completing the study.