Fecal Microbiota Transplantation: What We Know and What We Need to Know
Authors: Christina M. Surawicz
Journal: Annals of Internal Medicine (2015)

Editorials5 May 2015Fecal Microbiota Transplantation: What We Know and What We Need to KnowChristina M. Surawicz, MDChristina M. Surawicz, MDFrom University of Washington School of Medicine, Seattle, Washington.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-0609 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Recurrent Clostridium difficile infection (CDI) is the recurrence of infection and symptoms after successful initial therapy for C. difficile with resolution of symptoms. The risk for a first recurrence is 10% to 20%, but the rate increases to 40% to 60% after 1 recurrence. Recurrent CDI is difficult to treat, even with pulsed antibiotic regimens and probiotics. Patients who have several recurrences become debilitated and discouraged, and some believe that they may never get rid of the infection. Fecal microbiota transplantation (FMT) has emerged as an excellent therapy for these patients when all other options are unsuccessful.Fecal microbiota transplantation ...References1. van Nood E, Vrieze A, Nieuwdorp M, Fuentes S, Zoetendal EG, de Vos WM, et al. Duodenal infusion of donor feces for recurrent Clostridium difficile. N Engl J Med. 2013;368:407-15. [PMID: 23323867] doi:10.1056/NEJMoa1205037 CrossrefMedlineGoogle Scholar2. Surawicz CM, Brandt LJ, Binion DG, Ananthakrishnan AN, Curry SR, Gilligan PH, et al. Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections. Am J Gastroenterol. 2013;108:478-98. [PMID: 23439232] doi:10.1038/ajg.2013.4 CrossrefMedlineGoogle Scholar3. Debast SB, Bauer MP, Kuijper EJ; European Society of Clinical Microbiology and Infectious Diseases. European Society of Clinical Microbiology and Infectious Diseases: update of the treatment guidance document for Clostridium difficile infection. 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Randomised clinical trial: faecal microbiota transplantation by colonoscopy vs. vancomycin for the treatment of recurrent Clostridium difficile infection. Aliment Pharmacol Ther. 2015. [PMID: 25728808] doi:10.1111/apt.13144 CrossrefMedlineGoogle Scholar8. Konijeti GG, Sauk J, Shrime MG, Gupta M, Ananthakrishnan AN. Cost-effectiveness of competing strategies for management of recurrent Clostridium difficile infection: a decision analysis. Clin Infect Dis. 2014;58:1507-14. [PMID: 24692533] doi:10.1093/cid/ciu128 CrossrefMedlineGoogle Scholar9. Brandt LJ, Aroniadis OC, Mellow M, Kanatzar A, Kelly C, Park T, et al. Long-term follow-up of colonoscopic fecal microbiota transplant for recurrent Clostridium difficile infection. Am J Gastroenterol. 2012;107:1079-87. [PMID: 22450732] doi:10.1038/ajg.2012.60 CrossrefMedlineGoogle Scholar10. Chang JY, Antonopoulos DA, Kalra A, Tonelli A, Khalife WT, Schmidt TM, et al. Decreased diversity of the fecal Microbiome in recurrent Clostridium difficile–associated diarrhea. J Infect Dis. 2008;197:435-8. [PMID: 18199029] doi:10.1086/525047 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Christina M. Surawicz, MDAffiliations: From University of Washington School of Medicine, Seattle, Washington.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-0609.Corresponding Author: Christina M. Surawicz, MD, Harborview Medical Center, Box 359773, 325 9th Avenue, Seattle, WA 98104; e-mail, [email protected]washington.edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoFecal Microbiota Transplantation for Clostridium difficile Infection Dimitri Drekonja , Jon Reich , Selome Gezahegn , Nancy Greer , Aasma Shaukat , Roderick MacDonald , Indy Rutks , and Timothy J. Wilt Fecal Microbiota Transplantation for Clostridium difficile Infection Dimitri Drekonja , Jon Reich , Selome Gezahegn , Nancy Greer , Aasma Shaukat , Roderick MacDonald , Indy Rutks , and Timothy J. Wilt Metrics Cited byMethods and Reporting Studies Assessing Fecal Microbiota Transplantation A Systematic ReviewAïda Bafeta, PhD, Amelie Yavchitz, MD, PhD, Carolina Riveros, MSc, Rui Batista, PharmD, and Philippe Ravaud, MD, PhDFMT Happens: Regulating Fecal Microbiota Therapy in Canada; What You Need to KnowFecal transplant to mitigate hyperammonemia and hepatic encephalopathy in animal models 5 May 2015Volume 162, Issue 9Page: 662-663KeywordsClostridium infectionsFecal microbiota transplantFood and Drug AdministrationSafety studiesSurgerySystematic reviewsTransplantationTreatment guidelinesVancomycin ePublished: 5 May 2015 Issue Published: 5 May 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...