title: [Fecal microbiota transplantation in relapsing clostridium difficile colitis].
abstract: BACKGROUND
  Since the turn of the millennium there has been an alarming increase in the incidence and severity of clostridium difficile infections. Stopping medication with the triggering antibiotic and switching to a recommended antibiotic leads to healing up in 80%. However, patients who relapse have a 40% risk of an additional relapse and those with 2 or more episodes face a 60% risk. Fecal microbiota transplantation (FMT) is a new therapeutic option. Up to now there only exist two randomized studies (University of Amsterdam and the Massachusetts General Hospital in Boston).
  
  
  METHODS
  Data from 16 patients with recurrent clostridium difficile infection who had undergone FMT at a local hospital in the city of Bremen, Germany, were reviewed and compared to the results of the 2 randomized studies.
  
  
  RESULTS
  11 out of 16 patients got cured after the first FMT (68.75%). The remaining 5 patients received a second FMT, with cure in 3 patients. The overall response rate was 14 from 16 patients (87.5%).
  
  
  CONCLUSIONS
  In comparison to the response rates of the University of Amsterdam (81.3% after the first and 93.8% after the second FMT) and of the Massachusetts General Hospital in Boston (70% after the first and 90% after the second FMT) we received slightly worse results. But, treatment of notably older patients and intensive care patients in our group explain these findings well. Therefore, we advocate a wide use of FMT for the treatment of recurrent clostridium difficile colitis in non-university hospitals.
authors.affiliation: Klinik für Innere Medizin, Klinikum Links der Weser, Bremen, Deutschland. bernhard.ramsauer@klinkum-bremen-ldw.de.|Klinikum Links der Weser, Senator-Weßling-Straße 1, 28277, Bremen, Deutschland. bernhard.ramsauer@klinkum-bremen-ldw.de.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Ramsauer
authors.affiliation: Klinik für Innere Medizin, Klinikum Links der Weser, Bremen, Deutschland.
authors.forename: Christel
authors.initials: C
authors.lastname: König
authors.affiliation: Klinik für Innere Medizin, Klinikum Links der Weser, Bremen, Deutschland.
authors.forename: Tobias
authors.initials: T
authors.lastname: Sabelhaus
authors.affiliation: Medizinische Klinik II, Klinikum Bremen Mitte, Bremen, Deutschland.
authors.forename: Johann
authors.initials: J
authors.lastname: Ockenga
authors.affiliation: Klinik für Innere Medizin, Klinikum Links der Weser, Bremen, Deutschland.
authors.forename: Jan-Michel
authors.initials: JM
authors.lastname: Otte
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016360:Clostridioides difficile; D003113:Colonoscopy; D016292:Procedural Sedation; D004761:Enterocolitis, Pseudomembranous / Q000628:therapy*; D000069467:Fecal Microbiota Transplantation; D005243:Feces / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D019233:Retreatment; D012189:Retrospective Studies
keywords: Clostridium difficile; colitis; fecal microbiota transplantation