title: Fecal microbiota transplantation in the treatment of Clostridium difficile infections.
abstract: In recent years, Clostridium difficile infections have become more frequent, more severe, more refractory to standard treatment, and more likely to recur. Current antibiotic treatment regimens for Clostridium difficile infection alter the normal gut flora, which provide colonization resistance against Clostridium difficile. Over the past few years, there has been a marked increase in the knowledge of the gut microbiota and its role in health maintenance and disease causation. This has, fortuitously, coincided with the use of a unique microbial replacement therapy, fecal microbiota transplantation, in the treatment of patients with multiple recurrent Clostridium difficile infections. We briefly review current knowledge of the gut microbiota's functions. We then review the indications for use of fecal microbiota transplantation in Clostridium difficile infection, the techniques employed, and results of treatment. Fecal microbiota transplantation has been shown to be efficacious for patients with multiply recurrent Clostridium difficile infections (reported cure rates of 90%), with an excellent short-term safety profile, and has been included in the American College of Gastroenterology treatment guidelines for this troublesome disease.
authors.affiliation: Department of Internal Medicine, University of Oklahoma Health Science Center, Oklahoma City. Electronic address: matthew-austin@ouhsc.edu.
authors.forename: Matthew
authors.initials: M
authors.lastname: Austin
authors.affiliation: Digestive Health Center, Integris Baptist Medical Center, Oklahoma City, Okla.
authors.forename: Mark
authors.initials: M
authors.lastname: Mellow
authors.affiliation: Department of Internal Medicine, Section of Digestive Diseases, University of Oklahoma Health Science Center, Oklahoma City.
authors.forename: William M
authors.initials: WM
authors.lastname: Tierney
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D016360:Clostridioides difficile; D004761:Enterocolitis, Pseudomembranous / Q000188:drug therapy / Q000382:microbiology / Q000628:therapy*; D005243:Feces / Q000382:microbiology*; D006801:Humans; D064307:Microbiota; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Clostridium difficile infections; Diarrhea; Fecal microbiota transplantation; Gut microbiota