Fecal Transplantation for C. Difficile-associated Disease
Fecal Transplantation for C. Difficile-associated Disease
Management of severe, recurrent and relapse CDAD, particularly in elderly patients, remains clinically challenging. Transplantation of faecal suspension obtained from healthy donors may restore normal microbiota, breaking the cycle of recurrent CDAD, usually after treatment with pulsed/tapered vancomycin therapy has failed.
Based on the limited evidence from seven case series studies, FT appears to be a safe procedure. In most cases (83%), symptoms improved immediately after the first FT procedure and patients stayed diarrhoea free for several months or even years, indicating that FT could be an effective alternative in the treatment of patients with recurrent/refractory CDAD. Although these results appear to be promising, the treatment effects of FT cannot be determined definitively in the absence of a control group. Results from the two RCTs that are comparing FT to oral vancomycin without or with a taper regimen in patients with recurrent CDAD may help to better define the role of FT in the management of this patient population.
Conclusions
Management of severe, recurrent and relapse CDAD, particularly in elderly patients, remains clinically challenging. Transplantation of faecal suspension obtained from healthy donors may restore normal microbiota, breaking the cycle of recurrent CDAD, usually after treatment with pulsed/tapered vancomycin therapy has failed.
Based on the limited evidence from seven case series studies, FT appears to be a safe procedure. In most cases (83%), symptoms improved immediately after the first FT procedure and patients stayed diarrhoea free for several months or even years, indicating that FT could be an effective alternative in the treatment of patients with recurrent/refractory CDAD. Although these results appear to be promising, the treatment effects of FT cannot be determined definitively in the absence of a control group. Results from the two RCTs that are comparing FT to oral vancomycin without or with a taper regimen in patients with recurrent CDAD may help to better define the role of FT in the management of this patient population.
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