Home E-Weekly July 11, 2017

Are Fecal Transplants the Cure for Recurrent C. diff?

Published: July 10, 2017

MIRACLE POOP? Fecal transplants restore missing microbial flora to the gut of a fecal transplant recipient.

Could fecal transplants be a more effective treatment than antibiotics against recurrent Clostridium difficile? Researchers are cautiously optimistic that infusing a healthy donor's stool into a C. diff patient will repopulate the colon with healthy bacteria and prevent a recurrence.

For a study published in the Annals of Internal Medicine, researchers from the University of Pennsylvania's Perelman School of Medicine tracked the nationwide prevalence of C. diff from 2001 to 2012 — with data from nearly 39 million patients — and found that:

  • cases of multiple recurring C. diff increased by 189%;
  • cases of common C. diff increased by 43%; and
  • women over 55 were the most common C. diff victims, especially those who'd been exposed to corticosteroids, proton-pump inhibitors and/or antibiotics.

The researchers also were intrigued by a 2013 study of 43 patients that found that fecal transplant treatments were effective in 81% of recurrent C. diff patients, versus a 31% success rate with patients who were given repeated and extended courses of vancomycin, the conventional treatment.

The researchers say that while infusing donor feces is a potentially safe and effective treatment against recurrent C. diff, they say more data is needed to establish the long-term safety of the procedure. They also note that antibiotic treatment for an initial C. diff infection typically doesn't induce a durable response in about 15 to 26% of patients and that an effective treatment against recurrent C. diff is not available.

In a fecal transplant, fecal matter is collected from a tested donor, mixed with a saline or other solution, strained and then infused in a patient by colonoscopy, endoscopy, sigmoidoscopy or enema. The goal is to replace favorable bacteria — in this case, bacteria that helps prevent C. diff — that's been killed or suppressed, usually by antibiotics.

Jim Burger

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