Fecal Microbiota Transplantation Aids Resolution of Recurrent C difficile

The use of FMT in immunocompetent adults with recurrent C difficile infection leads to significant increase in resolution.

HealthDay News For immunocompetent adults with recurrent Clostridioides difficile infection (rCDI), fecal microbiota transplantation (FMT) yields a significant increase in resolution compared with alternative treatments, according to a review published online April 25 in the Cochrane Library.

Nathan Zev Minkoff, M.D., from Valley Children’s Hospital in Madera, California, and colleagues examined the benefits and harms of donor-based FMT for treatment of rCDI in immunocompetent adults vs placebo, autologous FMT, no intervention, or antibiotics. Data were pooled from 6 studies with 320 adult participants.

Researchers found that use of FMT in immunocompetent participants with rCDI likely leads to a large increase in resolution of rCDI compared with control (risk ratio, 1.92; 95% confidence interval, 1.36 to 2.71; P = 0.02). FMT probably yields a slight reduction in serious adverse events, but the investigators did not find a significant association (risk ratio, 0.73; 95% confidence interval, 0.38 to 1.41; P = 0.24). FMT may reduce the risk for all-cause mortality, but the number of events was small and confidence intervals were wide (risk ratio, 0.57; 95% confidence interval, 0.22 to 1.45; P = 0.48).

“The risk of recurrence increases to about 40% with the second episode and to nearly 60% with the third episode. So, once you are in this cycle, it gets more and more difficult to break out of it,” a coauthor said in a statement. “Stool transplants can reverse the dysbiosis and thus decrease the risk of recurrence of the disease.”

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