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2020 ; 7
(5
): ofaa114
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
The Efficacy and Safety of Fecal Microbiota Transplant for Recurrent Clostridium
difficile Infection: Current Understanding and Gap Analysis
#MMPMID32405509
Wilcox MH
; McGovern BH
; Hecht GA
Open Forum Infect Dis
2020[May]; 7
(5
): ofaa114
PMID32405509
show ga
The leading risk factor for Clostridioides (Clostridium) difficile infection
(CDI) is broad-spectrum antibiotics, which lead to low microbial diversity, or
dysbiosis. Current therapeutic strategies for CDI are insufficient, as they do
not address the key role of the microbiome in preventing C. difficile spore
germination into toxin-producing vegetative bacteria, which leads to symptomatic
disease. Fecal microbiota transplant (FMT) appears to reduce the risk of
recurrent CDI through microbiome restoration. However, a wide range of efficacy
rates have been reported, and few placebo-controlled trials have been conducted,
limiting our understanding of FMT efficacy and safety. We discuss the current
knowledge gaps driven by questions around the quality and consistency of clinical
trial results, patient selection, diagnostic methodologies, use of suppressive
antibiotic therapy, and methods for adverse event reporting. We provide specific
recommendations for future trial designs of FMT to provide improved quality of
the clinical evidence to better inform treatment guidelines.