Does 'Stool Transplantation' Work?
An Unconventional Therapeutic Approach for Clostridium difficile Infection
Albert B. Lowenfels, MD
DisclosuresApr 23, 2013
Is "stool transplantation" an effective therapeutic option for the management of recurrent Clostridium difficile infection? The investigators performed a small randomized trial in 42 patients with recurrent C difficile infection. A duodenal infusion of feces from 1 or more healthy donors was given to 16 patients, 13 patients received vancomycin only, and 13 received vancomycin with bowel lavage.
null
In the duodenal infusion group, 15 of 16 patients were considered cured after 2 treatments, compared with 4 of 13 patients receiving vancomycin (P < .001) and 3 of 13 patients receiving vancomycin with bowel lavage (P < .001). Initial diarrhea was the main adverse event in the infusion group, but it did not occur during follow-up.
Viewpoint
The investigators used stool infusion -- an unconventional therapeutic approach for the management of recurrent C difficile infection, which is a troublesome clinical problem. The results were very effective, and this randomized trial greatly strengthens previously available anecdotal reports.
One of the findings in this report is that diversity of the microbiota in the bowel of patients with C difficile infection is significantly reduced compared with that in healthy persons, and that infusion of stool from a healthy donor restores stool bacterial diversity. On the basis of this report, patients with recurrent C difficile infection can now benefit from this inexpensive yet effective treatment.
http://www.medscape.com/viewarticle/782443