A single fecal transplantation is not more effective than the existing standard of care — administration of oral vancomycin taper — for treating patients with recurrent Clostridium difficile infection, according to a study published in Clinical Infectious Diseases.
Canadian researchers examined patients experiencing an acute episode of recurrent C. diff. These study participants were randomly assigned to receive either 14 days of oral vancomycin therapy followed by a single fecal transplantation via enema or a six-week taper of oral vancomycin only.
The researchers terminated the study after analyzing results for the first 30 patients, as they found no significant difference between the two treatments for recurrent C. diff. An additional futility analysis shows that had the study been completed, it is highly unlikely that fecal transplantation would be proven more beneficial than oral vancomycin taper.
"In light of our results, I would caution a blanket approach of [fecal transplantation] to treat [recurrent C. diff infection]," said Susy Hota, MD, medical director of the infection prevention and control program at University Health Network in Toronto, Ontario, Canada. "The FT field is still evolving and, given as yet undefined long-term effects of manipulating the gut's microbiota, it should be approached with caution."