Fecal microbiota transplantation for Clostridium difficile infection: back to the future. (July 2015)

• Record Type: Journal Article
• Authors: Borgia, Guglielmo; Maraolo, Alberto Enrico; Foggia, Maria; Buonomo, Antonio Riccardo; Gentile, Ivan
• Is Part Of: Expert opinion on biological therapy. Volume 15:Number 7(2015:Jul.)
• Page Start: 1001
• Page End: 1014
• Publication Date: 2015-07
• Subjects: Gene therapy -- Periodicals; Protein drugs -- Periodicals; Peptide drugs -- Periodicals; Immunotherapy -- Periodicals; Drug delivery systems -- Periodicals; 615.5
• DOI: 10.1517/14712598.2015.1045872
• Languages: English
• ISSNs: 1471-2598

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <p> <bold> <italic>Introduction:</italic> </bold> <italic>Clostridium difficile</italic> infection (CDI) is a leading cause of diarrhea in the industrialized world. The estimated costs of this infection are impressive: over 3.2 billion dollars annually in the US. The introduction of fecal microbiota transplantation (FMT) to clinical practice can be considered a Copernican Revolution. The rationale of this approach consists of correcting the imbalance of the organisms dwelling in the gut by reintroducing a normal flora.</p> <p> <bold> <italic>Areas covered:</italic> </bold> This review focuses on the indication for FMT in CDI; it examines in-depth the most relevant aspects of the techniques used, and the safety and efficacy of this new 'old' therapy.</p> <p> <bold> <italic>Expert Opinion:</italic> </bold> Authoritative guidelines about the management of CDI strongly recommend FMT for multiple recurrent episodes of infection by <italic>C. difficile</italic> unresponsive to repeated antibiotic treatment. The cure rates are about 90%, with no serious adverse events having been reported. The main concerns are the long-term outcomes, lack of a standardized procedure for the delivery of donor material, and a cultural barrier to the transplantation of fecal microbiota. A promising solution to some of these problems could be the use of a more acceptable administration route of fecal material, namely, oral capsules.</p> </abstract>