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Fecal Bacteriotherapy Effective for Ongoing Clostridium Difficile Infection: Presented at UEGW By Jill Stein PARIS, FRANCE -- November 2, 2007 -- Fecal bacteriotherapy is a successful biological therapy for relapsing symptomatic Clostridium difficile (Cd) infection in patients who have failed available antibiotic therapy, researchers announced on October 31 at the 15th United European Gastroenterology Week (UEGW). Antony R. Wettstein, MD, a gastroenterologist and endoscopist at the Center for Digestive Diseases, Sydney, Australia, and colleagues reported the results of fecal bacteriotherapy when used at a single centre for the treatment and eradication of Cd infections. The 18 patients in whom the treatment was tested had longstanding symptoms including diarrhea, abdominal pain, nausea, flatulence, urgency, blood, mucus, and weight loss and Cd confirmed either by positive stool culture or positive Cd toxin A or B. All of them had failed prior antibiotics for Cd infection. Prior to fecal bacteriotherapy, patients underwent a 10-day course of bid rifampicin (150 mg), vancomycin (500 mg) or metronidazole (400 mg) antibiotics. One day before fecal bacteriotherapy, patients ingested 3L of polyethylene glycol orthostatic lavage. Fecal donors were screened for infectious diseases in blood and feces. Donors were either healthy relatives or unrelated healthy donors. Overall, fecal bacteriotherapy eradicated Cd in 94.44% of patients treated, Dr. Wettstein said. In patients without coexisting conditions, fecal bacteriotherapy had a 100% eradication rate and patients experienced immediate, complete resolution of symptoms. In patients with coexisting conditions, the treatment still achieved 88.89% Cd eradication and patients described a significant improvement in symptoms. One patient with inflammatory bowel syndrome relapsed 6 weeks after treatment following antibiotic use for an unrelated infection. However, 3 other patients remained negative for Cd despite reporting having used antibiotics post-fecal bacteriotherapy. No serious short or long-term events were observed in this study. Dr. Wettstein said that the results show that fecal bacteriotherapy is effective in this difficult-to-treat population of Cd patients who have failed antibiotic therapy. He added that while the approach is considered as a "treatment of last resort," its apparent safety and success mandate the need for additional investigations into the clinical uses of this treatment. [Presentation title: Fecal Bacteriotherapy -- An Effective Treatment for Relapsing Symptomatic Clostridium Difficile Infection. Abstract G-67] E-mail this page to a friend or colleague! To print, use this version