Faecal transplant for recurrent Clostridium difficile-associated diarrhoea: a UK case series

QJM. 2009 Nov;102(11):781-4. doi: 10.1093/qjmed/hcp118. Epub 2009 Sep 2.

Abstract

Background: Clostridium difficile-associated diarrhoea (CDAD) is an increasingly common and life threatening consequence of modern medical practice. Recurrent disease is seen in up to one-third of patients and there is no consensus on optimal therapy. Restoration of normal colonic flora addresses the underlying pathogenic mechanism in CDAD.

Methods: We describe the use of nasogastrically administered faecal transplant in the treatment of 15 patients with recurrent CDAD. Retrospective case note review was used to review the success and safety of therapy.

Results: Of 15 patients treated using this technique, 11 were cured of CDAD. Two patients required a further course of metronidazole after transplantation and one patient required a second treatment. One patient had recurrence of CDAD 4 weeks after treatment following a course of broad-spectrum antibiotics. No adverse events were noted.

Conclusion: In our experience, this technique is an effective and safe treatment for recurrent CDAD. Faecal transplantation via a nasogastric tube could be considered in patients with refractory relapsing CDAD.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Clostridioides difficile*
  • Diarrhea / epidemiology
  • Diarrhea / microbiology
  • Diarrhea / therapy*
  • Enterocolitis, Pseudomembranous / epidemiology
  • Enterocolitis, Pseudomembranous / microbiology
  • Enterocolitis, Pseudomembranous / therapy*
  • Feces / microbiology*
  • Female
  • Humans
  • Male
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • United Kingdom / epidemiology