Authors' objectives: Exposure to broad-spectrum antibiotics remains the greatest risk factor for Clostridium difficile infection (CDI), with some evidence suggesting that there is 8 to 10 times increased risk during and for 1 month after usage and 3 times increased risk for the next 2 months. Other risk factors for CDI include older age, gastrointestinal (GI) surgery, nasogastric tube feeding, reduced gastric acid, concurrent disease, use of immune suppressants, chronic dialysis, and residence in long-term care facilities. These factors, particularly antibiotics, cause disruption of the normal gut microbiota, or dysbiosis, thus enabling colonization of the GI tract by Clostridium difficile. Given the challenges in managing recurrent CDI, including increased risk of severe complications (e.g., septic shock, perforation), a number of experimental treatment options have been explored. Description of Technology: Fecal microbiota transplantation (FMT), a nonpharmacological approach to treat refractory or recurrent CDI, refers to a process in which stool obtained from a healthy donor is instilled into the GI tract of a patient with CDI. The aim is to recreate a normal and functional intestinal microbiota that will reestablish resistance to a subsequent pathogenic colonization. FMT may be delivered into the upper or lower GI tract via colonoscope, nasoduodenal or nasogastric tube, flexible sigmoidoscope, or rectal retention enema. Patient Population: FMT is used to treat adult patients (aged >= 18 years) with recurrent CDI or CDI that is refractory to standard courses of metronidazole and vancomycin. Clinical Alternatives: Metronidazole and vancomycin comprise the standard treatments for CDI, including recurrent CDI. Fidaxomicin has received Food and Drug Administration marketing approval for the treatment of diarrhea associated with Clostridium difficile. Alternatives under investigation include rifamixin; intravenous immunoglobulin; vaccination against Toxin A and B; and antitoxin vaccine.

Project Status: Completed

Year Published: 2016

URL for published report: The report may be purchased from: http://www.hayesinc.com/hayes/crd/?crd=48366

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: HAYES, Inc.

Contact Address: 157 S. Broad Street, Suite 200, Lansdale, PA 19446, USA. Tel: 215 855 0615; Fax: 215 855 5218

Contact Name: saleinfo@hayesinc.com

Contact Email: saleinfo@hayesinc.com

Copyright: 2014 Winifred S. Hayes, Inc