Treatment of recurrent ‘Clostridium difficile’ (RDA) with fecal microbe transplantation increased survival by almost 30%, reduced the length of hospital stay by half, and reduced the risk of sepsis by almost four times compared to antibiotic treatment, according to a prospective cohort study published in the journal ‘Annals of Internal Medicine’.
Recurrent RDA is often resistant to antibiotics and is associated with life-threatening complications, including bloodstream infections. A substantial proportion of patients are likely to develop bloodstream infections, most of which are caused by intestinal microbes and lead to death in more than 50% of patients. Fecal microbe transplantation (FMT) is more effective than antibiotics in the treatment of recurrent ICD.
Researchers at the Fondazione Policlinico Gemelli IRCCS, a tertiary academic center in Rome, Italy, compared the results of 290 patients hospitalized with recurrent ICD who were treated with either TMF or antibiotics. Five patients in the TMF group and 22 in the antibiotic group developed a bloodstream infection. Due to differences in patients treated with faecal transplantation versus antibiotics in many baseline characteristics, including number of recurrences and severity of RDA, comparative analyses were limited to a compatible cohort.
The risk of bloodstream infection was 23 percentage points lower in the faecal transplant group, which also had 14 days less hospitalization and a 32 percentage point increase in overall survival at 90 days compared to the antibiotic group.
Therefore, the researchers believe that these findings suggest that fecal transplantation may be an option not only to cure recurrent RDA but also to prevent its complications.