Duodenal infusion of donor feces for recurrent Clostridium difficile.

  title={Duodenal infusion of donor feces for recurrent Clostridium difficile.},
  author={Els van Nood and Annelike Vrieze and Max Nieuwdorp and Susana Fuentes and Erwin G. Zoetendal and Willem Meindert de Vos and Caroline Elisabeth Visser and Ed J. Kuijper and J. F.W.M. Bartelsman and Jan G. P. Tijssen and Peter Speelman and Marcel G. W. Dijkgraaf and Josbert J. Keller},
  journal={The New England journal of medicine},
  volume={368 5},
BACKGROUND Recurrent Clostridium difficile infection is difficult to treat, and failure rates for antibiotic therapy are high. [] Key MethodMETHODS We randomly assigned patients to receive one of three therapies: an initial vancomycin regimen (500 mg orally four times per day for 4 days), followed by bowel lavage and subsequent infusion of a solution of donor feces through a nasoduodenal tube; a standard vancomycin regimen (500 mg orally four times per day for 14 days); or a standard vancomycin regimen with…

Figures and Tables from this paper

Gut-sparing treatment of urinary tract infection in patients at high risk of Clostridium difficile infection

A brief (3 day) course of parenteral gentamicin was safe and effective in curing UTI in patients at high risk of C. difficile infection without perturbing their gut microbiota.

Oral Vancomycin Followed by Fecal Transplantation Versus Tapering Oral Vancomycin Treatment for Recurrent Clostridium difficile Infection: An Open-Label, Randomized Controlled Trial

  • S. HotaV. Sales S. Poutanen
  • Medicine
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2017
In patients experiencing an acute episode of recurrent CDI, a single FT by enema was not significantly different from oral vancomycin taper in reducing recurrentCDI, and further research is needed to explore optimal donor selection, FT preparation, route, timing, and number of administrations.

Fecal transplant in refractory Clostridium difficile colitis.

Fecal transplantation seems to be a safe and highly effective treatment for recurrent Clostridium difficile infection.

Stool therapy may become a preferred treatment of recurrent Clostridium difficile?

The significance of this trial cannot be underestimated as it lends credibility to the idea of intentionally using microbes to combat disease, providing an alternative to the older paradigm of disease eradication through use of antimicrobials.

Duodenal infusion of stool is more effective than vancomycin in patients with recurrent Clostridium difficile

This was the first open-label non-blinded clinical trial of faecal microbiota transplantation for recurrent Clostridium difficile infection and it showed promising results.

Fecal Transplant for Recurrent Clostridium difficile Infection in Children With and Without Inflammatory Bowel Disease

Ten children at this institution received single-infusion fecal microbiome transplant (FMT) using healthy, related screened donor stool to treat recurrent Clostridium difficile infection via nasogastric tube or colonoscopic delivery.

A Systematic Review of Fecal Microbiota Transplantation Versus Vancomycin for Treatment of Recurrent Clostridioides difficile Infection

  • J. LeungS. Pham
  • Medicine, Biology
    Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates
  • 2021
Evaluating the effectiveness of fecal microbiota transplantation in the resolution of recurrent Clostridioides difficile infection in adults, compared with an oral vancomycin regimen alone finds results are promising.

Fecal Transplantation using a Nasoenteric Tube during an Initial Episode of Severe Clostridium difficile Infection

This is the first reported case of fecal transplantation using a nasoenteric tube during an initial episode of C. difficile infection in Korea, and it may be an early treatment option for severe C. diffuse infection.

Fecal Microbiota Transplantation Is Superior to Fidaxomicin for Treatment of Recurrent Clostridium difficile Infection.

In a single-center randomized trial of patients with rCDI, the FMTv combination superior to fidaxomicin or vancomycin based on end points of clinical and microbiological resolution or clinical resolution alone was found.

Fecal Microbiota Transplantation After Oral Vancomycin for Recurrent Clostridium difficile Infection

Fecal microbiota transplantation preceded by a standard 2-week vancomycin regimen for the treatment of patients with rCDI seems to be safe and effective.



Fecal transplantation, through colonoscopy, is effective therapy for recurrent Clostridium difficile infection.

Fecal transplantation through colonoscopy seems to be an effective treatment for recurrentCDI and also for recurrent CDI caused by the virulent C difficile 027 strain.

Recurrent Clostridium difficile colitis: case series involving 18 patients treated with donor stool administered via a nasogastric tube.

  • J. AasC. GessertJ. Bakken
  • Medicine
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2003
Patients with recurrent C. difficile colitis may benefit from the introduction of stool from healthy donors via a nasogastric tube, according to retrospectively reviewed medical records.

[Treatment of recurrent Clostridium difficile-associated diarrhoea with a suspension of donor faeces].

Treatment with donor faeces seems promising for patients who develop repeated recurrences despite adequate therapy and could be valuable in the future during (local) epidemics of the PCR ribotype 027 strain.

Struggling with recurrent Clostridium difficile infections: is donor faeces the solution?

The literature regarding treatment with donor faeces for recurrent CDI is summarized, the FECAL trial, currently open for inclusion, is introduced, and evidence-based treatment strategies are lacking.

Whole-bowel irrigation as an adjunct to the treatment of chronic, relapsing Clostridium difficile colitis.

It is suggested that whole-bowel irrigation clears active C. difficile organisms, toxins, and spores from the intestine and is effective as an adjunct to routine therapy for chronic, relapsing C. Difficile infections.

Results of faecal donor instillation therapy for recurrent Clostridium difficile-associated diarrhoea

In the experience the procedure is easy to perform, well tolerated, effective, and may be a valuable treatment option in selected cases.

Fidaxomicin versus vancomycin for Clostridium difficile infection.

Fidaxomicin was associated with a significantly lower rate of recurrence of C. difficile infection associated with non–North American Pulsed Field type 1 strains and the adverse-event profile was similar for the two therapies.

Fecal Flora Reconstitution for Recurrent Clostridium difficile Infection: Results and Methodology

Fecal Flora Reconstitution is an effective, viable, and simple method of treatment for the difficult to treat patients with RCDI who fail standard therapy.

Systematic review of intestinal microbiota transplantation (fecal bacteriotherapy) for recurrent Clostridium difficile infection.

  • E. GoughHenna ShaikhA. Manges
  • Medicine, Biology
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2011
Effectiveness varied by route of instillation, relationship to stool donor, volume of IMT given, and treatment before infusion, but findings can guide physicians interested in implementing the procedure until better designed studies are conducted to confirm best practices.