Efficacy of Fecal Microbiota Transplant for treatment of recurrent Clostridium difficile infection
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Kalmar, D.; Marlow, R.; Micallef, J. 2021. Efficacy of Fecal Microbiota Transplant for treatment of recurrent Clostridium difficile infection -- In Proceedings: 17th Annual Symposium on Graduate Research and Scholarly Projects. Wichita, KS: Wichita State University
Clostridium difficile is a transmissible pathogen that causes an inflammatory infection in the colon with a high recurrence rate and complications. The toxins produced target the gut lining leading to the common symptom of diarrhea. A change of microbial diversity in the large intestine is the most agreed upon mechanism. This is commonly caused by antibiotic therapy. Recurrent Clostridium difficile infection (rCDI) has been associated with increased morbidity and mortality and lower quality of life. Current treatment guidelines for rCDI focus on antibiotic therapy until subsequent infections occur, influencing healthcare providers to consider Fecal Microbiota Transplant (FMT). FMT works based on the idea of replacing the diminished microbial gut flora by transplanting stool from a donor. Donors are screened to prevent the transmission of communicable disease to recipients. The purpose of our literature review was to assess the efficacy of FMT as a treatment for rCDI and how it compares to standard therapies such as antibiotics. Our target audience are healthcare providers who will manage Clostridium difficile infections. We compared current literature to the North American guidelines which were developed by the Infectious Disease Society of America and Society for Healthcare Epidemiology of America. The current literature supports FMT as the preferred treatment for rCDI, providing risk reduction and a superior cure rate when compared to other therapies such as antibiotics. We recommend that FMT should be used as a first-line treatment for rCDI instead of an antibiotic. We found that FMT was more cost-effective versus the current antibiotic treatment and the most effective delivery method is via colonoscopy. More random controlled trials with larger sample sizes are needed to investigate the mechanistic efficacy of FMT and what implications it has for other disease processes.
Presented to the 17th Annual Symposium on Graduate Research and Scholarly Projects (GRASP) held online, Wichita State University, April 2, 2021.
Research completed in the Department of Physician Assistant, College of Health Professionals