Clinical Inquiries: How effective and safe is fecal microbial transplant in preventing C difficile recurrence?

Clinical Inquiries: How effective and safe is fecal microbial transplant in preventing C difficile recurrence? J Fam Pract. 2018 Jun;67(6):386-388 Authors: Meyers S, Shih J, Neher JO, Safranek S Abstract Fecal microbial transplant (fmt) is reasonably safe and effective. In patients who have had multiple Clostridium difficile infections (CDIs), fecal microbial transplant (FMT) results in a 65% to 80% cure rate with one treatment and 90% to 95% cure rate with repeated treatments compared with a 25% to 27% cure rate for antibiotics (strength of recommendation [SOR]: B, small open-label randomized controlled trials [RCTs]). Fresh and frozen donor feces, administered by either nasogastric tube or colonoscope, produce equal results (SOR B, RCTs). FMT has an overall adverse event rate of 30%, primarily involving abdominal discomfort, but also, rarely, severe infections (0.7%) and death (0.1%) (SOR: B, systematic review not limited to RCTs). PMID: 29879241 [PubMed - in process]
Source: The Journal of Family Practice - Category: Practice Management Authors: Tags: J Fam Pract Source Type: research

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Abstract Recurrent Clostridioides (formerly Clostridium) difficile infection (rCDI) is common, and patients who have had one recurrence are more likely to have multiple recurrences. Frequent recurrences have been associated with increased morbidity and mortality, high healthcare costs, and lower quality of life. In this review, we compare the efficacy of interventions designed to prevent rCDI. We performed a systematic review of the English literature, including randomized controlled trials (RCTs) that evaluated rCDI as an outcome. Studies were included irrespective of patient demographics, disease severity, type ...
Source: Anaerobe - Category: Microbiology Authors: Tags: Anaerobe Source Type: research
We report results in 10 adult patients colonized with multidrug-resistant bacteria, undergoing fecal microbiota transplantation before (n=4) or after (n=6) allogeneic hematopoietic stem cell transplantation for hematologic malignancies. Stools were obtained from healthy related or unrelated donors. Fecal material was delivered either by enema or via nasogastric tube. Patients were colonized or had infections from either carbapenemase-producing bacteria (n=8) or vancomycin-resistant enterococci (n=2). The median age at fecal microbiota transplantation was 48 (range 16-64) years. Three patients needed a second transplant fro...
Source: Haematologica - Category: Hematology Authors: Tags: Haematologica Source Type: research
In conclusion, FMT proved to be very effective, particularly in recurrent infections and in cases where conventional treatment had failed. PMID: 30585500 [PubMed - as supplied by publisher]
Source: Acta Microbiologica et Immunologica Hungarica - Category: Microbiology Authors: Tags: Acta Microbiol Immunol Hung Source Type: research
CONCLUSIONS: This case series confirms that FMT is a safe and effective therapy for recurrent CDAD. In most cases it can be administered via the nasogastric route in the outpatient department. We propose that the recently published South African Gastroenterology Society guidelines be reviewed with regard to recommendations for the route of administration of FMT and hospital admission. Meticulous prescription practice by clinicians practising in hospitals and outpatient settings, with particular attention to antimicrobials and chronic medication, is urgently required to prevent this debilitating and potentially life-threate...
Source: South African Medical Journal - Category: African Health Tags: S Afr Med J Source Type: research
In this study, our objective was to evaluate the rate of resolution of diarrhea following administration of lyophilized and resolved FMT via a nasogastric (NG) tube. We recruited 19 patients suffered from laboratory-confirmed C. difficile infection. Each of them was treated by lyophilized and resolved inoculum through a NG tube. One participant succumbed following the procedure due to unrelated diseases. Out of 18 cases, 15 patients reportedly experienced a resolution of the symptoms. One patient was treated with another course of antibiotics, and two of the non-responders were successfully retreated with another course of...
Source: Acta Microbiologica et Immunologica Hungarica - Category: Microbiology Authors: Tags: Acta Microbiol Immunol Hung Source Type: research
Abstract: Clostridium difficile infection (CDI) is the most common hospital-acquired infection in the United States. Fecal microbiota transplant (FMT) has become a highly efficacious therapy for recurrent mild/moderate disease; however, the efficacy and optimal delivery method in severe/complicated disease is unknown. A retrospective chart review was performed for all FMT recipients at the University of Alabama at Birmingham. Those with severe/complicated disease were isolated and their clinical course documented via chart review and phone calls. Eight patients with severe/complicated CDI who received FMT via both lower an...
Source: Infectious Diseases in Clinical Practice - Category: Infectious Diseases Tags: Original Articles Source Type: research
We present our experience with FMT via fluoroscopic-guided nasojejunal catheter placement. The discussion will include indications and contraindications, protocol, and procedural technique, and include a case presentation incorporating original CT and fluoroscopic images. Specifically, we will address the advantages and disadvantages of image-guided FMT via the upper GI tract with respect to nasogastric-, colonoscopic-, and enema-based delivery. The efficacy of FMT for the treatment of C. difficile has been widely demonstrated in several prospective and case studies. We feel that nasojejunal FMT is an underutilized radiolo...
Source: Abdominal Imaging - Category: Radiology Source Type: research
This article reviews the efficacy and safety of FMT used in treating a variety of diseases, methodology, criteria for donor selection and screening, and various concerns regarding FMT. PMID: 26956193 [PubMed - as supplied by publisher]
Source: Clinical Endoscopy - Category: Gastroenterology Tags: Clin Endosc Source Type: research
Bath time and bubbles, snuggling with Mom and playing hockey with his big brother are just a few of Kaleb’s favorite things. But for the bright-eyed three-year-old from Massachusetts, things weren’t always so carefree. Kaleb’s health changes: Battling ear infections and diarrhea As an infant, Kaleb was a healthy baby boy. He was eating well and growing by leaps and bounds. At six months, his health began to change. Multiple ear infections followed by numerous antibiotic treatments became a painful part of Kaleb’s young life. As his first birthday approached, a second, unrelated condition emerged. Bo...
Source: Thrive, Children's Hospital Boston - Category: Pediatrics Authors: Tags: All posts Diseases & conditions Center for Inflammatory Bowel Disease (IBD) fecal transplant gastroenterology George Russell Mark Volk Poop pill Source Type: news
Abstract Clostridium difficile ribotype 027 (CD027)-associated diarrhea preferentially affects elderly patients and causes a high mortality rate. Fecal microbiota transplantation has become an alternative treatment for recurrent C. difficile infections. An outbreak of CD027 infections has occurred in Marseille since March 2013. From March to November 2013, we treated patients using only antibiotics or fecal microbiota transplantation after at least three relapses. Beginning in November 2013, we performed early transplantation using a nasogastric tube during the first week of infection, in combination wi...
Source: European Journal of Clinical Microbiology and Infectious Diseases - Category: Microbiology Source Type: research
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