Donor vs. Autologous Fecal Microbiota Transplant Assessed for C. difficile Infection

Donor stool safe, more efficacious than autologous transplantation in preventing <i>C. difficile</i>
Donor stool safe, more efficacious than autologous transplantation in preventing C. difficile

HealthDay News — For patients with recurrent Clostridium difficile infection (CDI), donor fecal microbiota transplantation (FMT) is safe and more efficacious than autologous FMT, according to a study published online August 23 in the Annals of Internal Medicine.

In an effort to examine the efficacy and safety of FMT, Colleen R. Kelly, MD, from the Warren Alpert Medical School of Brown University in Providence, RI, and colleagues conducted a randomized trial involving 46 patients at two academic medical centers with three or more recurrences of CDI. Patients were randomized to FMT with donor stool or patient's own stool administered by colonoscopy.

In intention-to-treat analysis, the researchers found that 90.9% of patients in the donor FMT group achieved clinical cure, compared with 62.5% in the autologous FMT group (P=0.042). There was variation by site in resolution after autologous FMT (nine of 10 versus six of 14; P=0.033). For the nine patients who developed recurrent CDI after autologous FMT, there were no further episodes of CDI after subsequent donor FMT. No FMT-related serious adverse events were observed. Gut bacterial community diversity and composition were restored by donor FMT to resemble that of healthy donors.

"Donor stool administered via colonoscopy seemed safe and was more efficacious than autologous FMT in preventing further CDI episodes," the authors write.

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