A recent study published in the journal Gastroenterology has given the green light to fecal microbiota-based therapies for certain patients with recurrent Clostridioides difficile (C.difficile) infections. The study, conducted by the American Gastroenterological Association (AGA), recommends these therapies for immunocompetent and mildly to moderately immunocompromised adults. However, severely immunocompromised patients should only consider this treatment as a last resort. The guidelines were established by a panel of seven experts who gathered evidence from various electronic databases.
C.difficile infections pose a significant health threat, with 462,000 new cases diagnosed annually in the United States alone. The infection is more prevalent among individuals over the age of 65 and those who spend prolonged periods in assisted living. Symptoms of C.difficile include loose and watery stools, fever, and stomach tenderness. For patients who do not respond to antibiotics within 2 to 5 days of treatment or after their third infection, fecal microbiota-based therapies, such as fecal transplants, can be considered.
The study emphasizes that fecal transplants should not be recommended for patients with other gastrointestinal conditions, such as inflammatory bowel diseases like ulcerative colitis or Crohn’s disease, except in the context of clinical studies. Alternative treatments for C.difficile infections include a vancomycin taper, tapered-pulsed fidaxomicin, or bezlotoxumab. The authors of the research highlight the effectiveness of fecal microbiota-based therapies in preventing recurrent C.difficile infections but stress that further studies are needed to determine its efficacy in treating other gastrointestinal disorders.
