• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home The Classics General Medicine Classics

Fecal transplantation in recurrent C. difficile infection [Classics Series]

byAndrew Cheung, MD MBA
September 17, 2014
in General Medicine Classics, Surgery Classics, The Classics
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. Treating recurrent C. difficile infection with infusion of donor feces resulted in significantly higher cure rates than treating with vancomycin-alone or vancomycin with bowel lavage.

2. Adverse events immediately after feces infusion included diarrhea, cramping, and belching.

Original Date of Publication: January 31, 2013

Study Rundown: Previous studies have demonstrated that vancomycin is superior to metronidazole in treating severe Clostridium difficile-associated diarrhea, and that fidaxomicin is non-inferior to vancomycin in achieving clinical cure of C. difficile infection, but significantly reduces the rate of recurrence. In many patients, however, antibiotic treatment does not lead to sustained response, and these patients often require repeated or long tapering courses of vancomycin in attempts to achieve cure. While many factors have been blamed for C. difficile recurrence, one commonly cited reason is the destruction of the normal intestinal flora from repeated bouts of antibiotic therapy. Earlier non-randomized trials had explored the efficacy of gastrointestinal infusions of feces from healthy donors to treat recurrent C. difficile infection, and the results were promising. The purpose of this small randomized, controlled trial was to explore the efficacy of donor feces infusion in treating recurrent C. difficile infection.

In summary, patients receiving donor feces infusion were significantly more likely to achieve cure without relapse in the 10 weeks after starting therapy. While these results are promising, larger, multicentre trials are needed to study the generalizability of these findings. Moreover, trials with longer follow-up are necessary to assess the duration of the effect.

Click to read the study in NEJM

In-Depth [randomized controlled trial]: This open-label, randomized, controlled trial was originally published in NEJM in 2013. Participants in the trial were randomized to three treatment groups: 1) infusion of donor feces (preceded by a short course of vancomycin and bowel lavage), 2) a standard vancomycin regimen, and 3) a standard vancomycin regimen with bowel lavage. Patients were eligible for the trial if they were >18 years old, had a life expectancy >3 months, and had a relapse of C. difficile after an adequate course of antibiotics (≥10 days of vancomycin or metronidazole). Exclusion criteria included recent chemotherapy, HIV infection with CD4<240, prolonged use of prednisolone ≥60 mg daily, pregnancy, use of antibiotics for other infections, and admission to intensive care or requiring vasopressors. Patients who experienced recurrence after the first infusion were given a second infusion from a different donor. The primary endpoint was cure without relapse in the 10 weeks after starting therapy, or 10 weeks after the second infusion.

RELATED REPORTS

Oral microbiome therapy reduced Clostridioides difficile recurrence

Very-low-calorie diet leads to significant but reversible changes in gut microbiome

Wellness Check: Nutrition

A total of 43 patients underwent randomization. In the feces infusion group, 81% of patients were cured after the first infusion, and 94% were cured overall. Cure rates were 31% and 23% for the vancomycin-alone and vancomycin with lavage groups, respectively. Patients in the feces infusion group had significantly higher rates of cure (P<0.01 for both comparisons after one infusion, P<0.001 for overall cure rate). Most patients (94%) had diarrhea immediately after receiving donor feces, while cramping (31%) and belching (19%) were also common. These symptoms resolved within 3 hours in all patients.

Image: PD

©2012-2014 2minutemedicine.com. All rights reserved. No works may be reproduced without written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT. Content is produced in accordance with fair use copyrights solely and strictly for the purpose of teaching, news and criticism. No benefit, monetary or otherwise, is realized by any participants or the owner of this domain.

Tags: C. difficileClostridium difficile
Previous Post

Device-guided breathing not associated with improved blood pressure control

Next Post

TASTE trial: Thrombus aspiration before PCI in STEMI does not reduce mortality

RelatedReports

[Physician Comment] The extent of C. difficile infections may not differ in light of immune status
Gastroenterology

Oral microbiome therapy reduced Clostridioides difficile recurrence

January 24, 2022
Of Background Image
Gastroenterology

Very-low-calorie diet leads to significant but reversible changes in gut microbiome

July 27, 2021
Provision of medically-tailored meals linked with lower admissions and medical spending
Wellness

Wellness Check: Nutrition

July 22, 2021
Molecular testing for Clostridium difficile may not predict disease activity
Gastroenterology

Quick Take: Trends in diverting loop ileostomy vs. total abdominal colectomy as surgical management for Clostridium Difficile colitis

July 12, 2019
Next Post
TASTE trial: Thrombus aspiration before PCI in STEMI does not reduce mortality

TASTE trial: Thrombus aspiration before PCI in STEMI does not reduce mortality

Most anticoagulants for venous thromboembolism similarly effective

Most anticoagulants for venous thromboembolism similarly effective

Renal stones in women linked with increased risk of coronary heart disease

Ultrasound as effective as CT at identifying high-risk kidney stones, reduces radiation exposure

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

Get 2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • #VisualAbstract: Severe actinic keratosis and need for additional treatment are markers for an increased risk of cutaneous squamous cell carcinoma
  • Virtual yoga and meditation intervention may be associated with increased health-related quality of life
  • Wellness Check: Mental Health
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.