Could Fecal Microbiota Transplant Reduce C. difficile Recurrence?

Donor stool transplantation is associated with reduced risk for Clostridium difficile (CD) recurrence, according to a recent study.

Data on the efficacy of fecal microbiota transplantation (FMT) for the treatment of recurrent CD infection is limited.
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To further investigate, researchers conducted a randomized, controlled, double-blind clinical trial involving 46 patients who had 3 or more recurrences of CD infection and received vancomycin during their most recent occurrence.

The participants were randomly assigned to receive either transplantation with donor stool (heterologous) or their own stool (autologous) administered via colonoscopy.

Overall, 20 of the 22 patients in the heterologous group achieved clinical cure compared with 15 of the 24 in the autologous group. The 9 participants who developed recurrent CDI after autologous FMT were free from further CD infection following subsequent heterologous transplant.

“Donor stool administered via colonoscopy seemed safe and was more efficacious than autologous FMT in preventing further CDI episodes.”

—Michael Potts

Reference:

Kelly CR, Khoruts A, Staley C, et al. Effect of fecal microbiota transplantation on recurrence in multiply recurrent clostridium difficile infection: a randomized trial [published online August 23, 2016]. Ann Intern Med. doi:10.7326/M16-0271