Endoscopic Fecal Microbiota Transplantation "First-Line'' Treatment for Severe Clostridium difficile Infection?

*Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY †Centre for Digestive Diseases, Australia.
Journal of clinical gastroenterology (Impact Factor: 3.5). 06/2011; 45(8):655-7. DOI: 10.1097/MCG.0b013e3182257d4f
Source: PubMed
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    • "All 12 patients (100%) experienced complete clinical response, supporting the clinical safety and efficacy of colonoscopyadministered FMT. Brandt et al. (2011) [4] An editorial highlighting FMT as a proposed first-line therapy for severe C. difficile infection The authors provide a brief overview of the literature describing the magnitude of the C. difficile problem in the modern healthcare environment. "
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    ABSTRACT: Fecal microbiota transplantation (FMT) has emerged as a viable adjunct to traditional therapies used in the treatment of Clostridium difficile colitis. Despite the encouraging early results, wider implementation of FMT continues to be limited by the paucity of high-quality clinical evidence and logistical challenges. The purpose of this evidence table is to present the reader with the most up-to-date information (years 2010-2015) regarding clinical FMT applications, including novel methods of delivery and outcome-based focus.
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    • "Several systematic review papers have claimed high effectiveness rates for recurrent CDI and other gastrointestinal disorders (e.g., van Nood, Speelman, Kujiper, and Keller, 2009, reported 91% [159 patients] and Landy et al., 2011, reported 87% [145/166 patients] for CDI). Brandt, Borody, and Campbell (2011) have suggested that fecal transplants be considered as a first-line treatment for recurrent CDI, citing the high effectiveness rate and cost-effectiveness in comparison with antibiotics. The documentation of effectiveness, however, has often relied on retrospective review of case reports (Guo et al., 2011). "
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    ABSTRACT: Advances in human microbiome research have generated considerable interest in elucidating the role of bacteria in health and the application of microbial ecosystem therapies and probiotics. Fecal transplants involve the introduction of gut microbes from a healthy donor's stool to the patient and have been documented as effective for treating Clostridium difficile infections (CDIs) and some other gastrointestinal disorders. However, the treatment has encountered regulatory hurdles preventing widespread uptake. We examined dominant representations of fecal transplants in Canadian media and found that fecal transplants are often represented as being inherently disgusting or distasteful (the "ick factor"). This "ick factor" is used to construct different messages about the treatment's social acceptability and legitimacy. We conclude that an over-emphasis on the "ick factor" constrains public discourse from a more nuanced discussion of the social challenges, scientific concerns, and regulatory issues surrounding the treatment. © The Author(s) 2015.
    Qualitative Health Research 01/2015; 25(10). DOI:10.1177/1049732314568199 · 2.19 Impact Factor
    • "The possibility of applying FMT in other chronic GI and non-GI illnesses is an area of investigation. Although the majority of studies focused on recurrent CDI, Brandt et al.,[62] advocated the use of FMT as a primary treatment for CDI, as it is safe, superior, and less costly than antibiotic use. "
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    ABSTRACT: Clostridium difficile infection (CDI) is currently a leading cause of antibiotic and health care-related diarrhea. The incidence and the severity of CDI-related diarrhea have increased dramatically in the USA and Europe in the past few decades. The emergence of multidrug-resistant hypervirulent strains of C. difficile has led to an increase in mortality. Fecal microbiota transplantation (FMT) (also known as fecal bacteriotherapy) has been utilized sporadically since the 1950s; and currently, the interest in using FMT has grown again in the past few years for the treatment of CDI and other chronic gastrointestinal diseases. FMT has shown to be effective, cheap, and has very few side effects. It is believed to manipulate and restore the gut microbiota, and therefore enhances the growth of "healthy" bacteria that break the cycle of recurrent CDI. This article focus on the recent case reports on FMT, and general approach to patients undergoing this therapy. Data were obtained through a literature search via PubMed and Google.
    North American Journal of Medical Sciences 06/2013; 5(6):339-43. DOI:10.4103/1947-2714.114163
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