title: Fecal Bacteriotherapy for Recurrent Clostridium difficile Infection: What's Old Is New Again?
abstract: In recent years, effective management of recurrent Clostridium difficile infection (CDI) has emerged as an important issue for those clinicians who treat patients with CDI. In addition to antibiotic-based therapies, including alternating use, chaser, and tapering protocols, interest has increased in the potential utility of a variety of nonantibiotic forms of adjunctive therapy. Among these alternative forms of treatment, the concept of transferring extracts of a stool from donors to patients with CDI has been met with great interest among researchers, clinicians, and patients alike. Fecal bacteriotherapy, or so-called fecal microbiota transplantation, for therapy of CDI is a procedure that dates back to the 1950s. Recently, however, a variety of studies have garnered attention in the lay press, in addition to the standard scientific-reporting community. Although no well-controlled trials have been published as yet and the details of the procedures used have varied widely between institutions, the available evidence suggests that for selected patients, fecal bacteriotherapy appears to be generally safe and effective. Concerns about true efficacy and the theoretical potential for infectious complications have prevented widespread adoption of this concept as standard therapy, but its use in academic and community practices is on the rise.
authors.affiliation: Division of Infectious Diseases and HIV Medicine, Case School of Medicine, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH, 44106, USA, nuntra.suwantarat@case.edu.
authors.forename: Nuntra
authors.initials: N
authors.lastname: Suwantarat
authors.forename: David A
authors.initials: DA
authors.lastname: Bobak
references.citation: J Clin Gastroenterol. 2010 May-Jun;44(5):354-60
references.pmid: 20048681
references.citation: Science. 2012 Jun 8;336(6086):1255-62
references.pmid: 22674335
references.citation: Science. 2012 Jun 8;336(6086):1262-7
references.pmid: 22674330
references.citation: Nature. 2010 Mar 4;464(7285):59-65
references.pmid: 20203603
references.citation: Clin Infect Dis. 2011 Nov;53(10):994-1002
references.pmid: 22002980
references.citation: Clin Infect Dis. 2012 Dec;55(12):1659-60
references.pmid: 22990845
references.citation: Science. 2012 Jun 8;336(6086):1268-73
references.pmid: 22674334
references.citation: J Clin Gastroenterol. 2012 Feb;46(2):145-9
references.pmid: 22157239
references.citation: J Infect Dis. 2008 Feb 1;197(3):435-8
references.pmid: 18199029
references.citation: Curr Infect Dis Rep. 2011 Feb;13(1):21-7
references.pmid: 21308451
references.citation: Surgery. 1958 Nov;44(5):854-9
references.pmid: 13592638
references.citation: J Clin Gastroenterol. 2010 Sep;44(8):551-61
references.pmid: 20716985
references.citation: Gastroenterology. 2012 Aug;143(2):e19; author reply e19-20
references.pmid: 22732575
references.citation: Science. 2012 Jun 8;336(6086):1245
references.pmid: 22674336
references.citation: mBio. 2012 Oct 23;3(5):
references.pmid: 23093385
references.citation: Gastroenterology. 2012 Mar;142(3):490-6
references.pmid: 22155369
references.citation: Am J Gastroenterol. 2012 Jul;107(7):1079-87
references.pmid: 22450732
references.citation: Am J Gastroenterol. 2012 May;107(5):761-7
references.pmid: 22290405
references.citation: N Engl J Med. 2013 Jan 31;368(5):407-15
references.pmid: 23323867
references.citation: Clin Infect Dis. 2012 Dec;55(12):1652-8
references.pmid: 22990849
references.citation: PLoS Pathog. 2012;8(10):e1002995
references.pmid: 23133377
references.citation: Aliment Pharmacol Ther. 2012 Apr;35(8):865-75
references.pmid: 22360412