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

J Fam Pract. 2018 Jun;67(6):386-388.

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).

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use*
  • Clostridium Infections / drug therapy*
  • Clostridium Infections / prevention & control*
  • Fecal Microbiota Transplantation / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Recurrence
  • Secondary Prevention / methods*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents