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.
    • "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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    ABSTRACT: Fecal microbiota transplantation (FMT) has been utilized sporadically for over 50 years. In the past few years, Clostridium difficile infection (CDI) epidemics in the USA and Europe have resulted in the increased use of FMT, given its high efficacy in eradicating CDI and associated symptoms. As more patients request treatment and more clinics incorporate FMT into their treatment repertoire, reports of applications outside of CDI are emerging, paving the way for the use of FMT in several idiopathic conditions. Interest in this therapy has largely been driven by new research into the gut microbiota, which is now beginning to be appreciated as a microbial human organ with important roles in immunity and energy metabolism. This new paradigm raises the possibility that many diseases result, at least partially, from microbiota-related dysfunction. This understanding invites the investigation of FMT for several disorders, including IBD, IBS, the metabolic syndrome, neurodevelopmental disorders, autoimmune diseases and allergic diseases, among others. The field of microbiota-related disorders is currently in its infancy; it certainly is an exciting time in the burgeoning science of FMT and we expect to see new and previously unexpected applications in the near future. Well-designed and well-executed randomized trials are now needed to further define these microbiota-related conditions.
    Nature Reviews Gastroenterology &#38 Hepatology 12/2011; 9(2):88-96. DOI:10.1038/nrgastro.2011.244 · 12.61 Impact Factor
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