Success of self-administered home fecal transplantation for chronic Clostridium difficile infection.
OBJECTIVE
Clostridium difficile infection (CDI) can relapse in patients with significant comorbidities. A subset of these patients becomes dependent on oral vancomycin therapy for prolonged periods with only temporary clinical improvement. These patients incur significant morbidity from recurrent diarrhea and financial costs from chronic antibiotic therapy.


METHODS
We sought to investigate whether self- or family-administered fecal transplantation by low volume enema could be used to definitively treat refractory CDI.


RESULTS
We report a case series (n = 7) where 100% clinical success was achieved in treating these individuals with up to 14 months of follow-up.


CONCLUSIONS
Fecal transplantation by low volume enema is an effective and safe option for patients with chronic relapsing CDI, refractory to other therapies. Making this approach available in health care settings has the potential to dramatically increase the number of patients who could benefit from this therapy.
Silverman
Michael S
MS
Department of Medicine, University of Toronto, Toronto, Ontario, Canada. mikesilverman@rogers.com
Davis
Ian
I
Pillai
Dylan R
DR
D000285:Administration, Rectal; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000382:microbiology / Q000628:therapy*; D005243:Feces; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012646:Self Administration / Q000379:methods*; D016896:Treatment Outcome