Researchers Conduct Systematic Review of Fecal Transplantation

Fecal transplantation is the process of transferring healthy stool into someone else’s gastrointestinal tract to reestablish a healthy diversity of bacteria. It certainly doesn’t sound glamorous or appealing, but despite the obvious ‘ick’ factor, this investigational procedure is gaining recognition as an exciting new therapy for Clostridium difficile (C. difficile or C. diff), a deadly bacterial infection that has increased significantly over the last several years.

C. diff can affect anyone, but it is most often picked up by patients in hospitals or long-term care facilities. According to the Centers for Disease Control and Prevention, C. diff was responsible for 500,000 infections in 2011, and 29,000 patients died within 30 days of diagnosis. Infection recurrence is also a significant concern, with 15 to 30 percent of patients experiencing recurrence after initial infection. These cases are typically much more difficult to treat, and the risk of recurrence increases with every subsequent episode (Source: Medscape).

Dimitri Drekonja, M.D., from the Minneapolis Veterans Affairs Health Care System in Minnesota, led a systematic review that examined the efficacy of fecal transplantation on recurrent C. diff infections. Drekonja and colleagues examined two randomized, controlled trials and 33 uncontrolled case reports involving over 500 fecal transplant patients with C. diff. Their research found that fecal transplantation was effective in treating 85 percent of recurrent C. diff infections. In patients who were resistant to standard drug treatments, fecal transplantation was effective 55 percent of the time.

Drekonja commented that C. diff infections are easily treated in about 90 percent of patients, but recurrence is seen at a relatively high rate. Antibiotic treatments have been the standard for quite some time, but because these drugs kill off both good and bad bacteria, they may actually contribute to recurrent episodes.

The review concluded that fecal transplantation appears to be an effective treatment with very few side effects. "I think this will be a hot area going forward," said Drekonja. "But the evidence we have so far does not meet the criteria of FDA guidance, which means that if this was a standard pill under development and brought to the FDA for approval with the information we now have, it would not be licensed."

Drekonja and his team of researchers plan to continue their study of fecal transplantation.

The results of this study are published in the May 5 issue of the Annals of Internal Medicine (Source: HealthDay).

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