Abstract
In recent years, Clostridium difficile infections have become more frequent, more severe, more refractory to standard treatment,
and more likely to recur. Current antibiotic treatment regimens for Clostridium difficile infection alter the normal gut flora, which provide colonization resistance against
Clostridium difficile. Over the past few years, there has been a marked increase in the knowledge of the
gut microbiota and its role in health maintenance and disease causation. This has,
fortuitously, coincided with the use of a unique microbial replacement therapy, fecal
microbiota transplantation, in the treatment of patients with multiple recurrent Clostridium difficile infections. We briefly review current knowledge of the gut microbiota's functions.
We then review the indications for use of fecal microbiota transplantation in Clostridium difficile infection, the techniques employed, and results of treatment. Fecal microbiota transplantation
has been shown to be efficacious for patients with multiply recurrent Clostridium difficile infections (reported cure rates of 90%), with an excellent short-term safety profile,
and has been included in the American College of Gastroenterology treatment guidelines
for this troublesome disease.
Keywords
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Article info
Publication history
Published online: February 27, 2014
Footnotes
Funding: None.
Conflicts of Interest: MM is on the speakers bureau for Optimer Pharmaceuticals (Dificid). The other authors have no potential conflicts of interest to report.
Authorship: All authors had access to all data and editions of the manuscript as well as contributing to the ideas, planning, and writing of this article.
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© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
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- Fecal Microbiota Transplantation: The Case of Immunocompromised PatientsThe American Journal of MedicineVol. 128Issue 3
- PreviewI read with great interest the review by Austin et al about fecal microbiota transplantation in the treatment of Clostridium difficile infections.1 They rightly point out that fecal microbiota transplantation is efficacious for patients with recurrent C. difficile infection, with an excellent short-term safety profile. However, I want to raise a safety concern for comment, that is, the case of immunocompromised patients not evoked by the authors.
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