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Fecal Microbiota Transplantation for Clostridium difficile Infection: A Systematic Review

Umair Iqbal, Hafsa Anwar, Muhammad A Karim
BACKGROUND AND AIMS: Fecal microbial transplantation (FMT) has been shown to be effective for the treatment of recurrent clostridium difficile infection (CDI). The efficacy and safety of freeze-dried encapsulated FMT for the treatment of recurrent CDI is unclear. We performed a systematic review to evaluate and analyze the current evidence in this respect. MATERIALS AND METHODS: A systematic literature search was performed using the PubMed, Embase, and Medline databases until December 2017 to identify all original studies that investigated the role of administration of encapsulated FMT in recurrent CDI...
April 23, 2018: European Journal of Gastroenterology & Hepatology
Phuc Le, Van T Nghiem, Patricia Dolan Mullen, Abhishek Deshpande
BACKGROUND Clostridium difficile infection (CDI) presents a substantial economic burden and is associated with significant morbidity. While multiple treatment strategies have been evaluated, a cost-effective management strategy remains unclear. OBJECTIVE We conducted a systematic review to assess cost-effectiveness analyses of CDI treatment and to summarize key issues for clinicians and policy makers to consider. METHODS We searched PubMed and 5 other databases from inception to August 2016. These searches were not limited by study design or language of publication...
April 2018: Infection Control and Hospital Epidemiology
Aïda Bafeta, Amelie Yavchitz, Carolina Riveros, Rui Batista, Philippe Ravaud
Background: Fecal microbiota transplantation (FMT) could be a novel treatment option for several chronic diseases associated with altered gut microbiota. Purpose: To examine the conduct and reporting of studies assessing FMT. Data Sources: Cochrane Central Register of Controlled Trials, PubMed, EMBASE, and Web of Science from inception to 31 January 2017. Study Selection: Two reviewers independently examined titles and abstracts to identify all English-language reports of human clinical studies assessing the safety or efficacy of FMT...
July 4, 2017: Annals of Internal Medicine
Sahil Khanna, Andrea Shin, Ciarán P Kelly
The purpose of this expert review is to synthesize the existing evidence on the management of Clostridium difficile infection in patients with underlying inflammatory bowel disease. The evidence reviewed in this article is a summation of relevant scientific publications, expert opinion statements, and current practice guidelines. This review is a summary of expert opinion in the field without a formal systematic review of evidence. Best Practice Advice 1: Clinicians should test patients who present with a flare of underlying inflammatory bowel disease for Clostridium difficile infection...
February 2017: Clinical Gastroenterology and Hepatology
Leisa L Marshall, Samuel Peasah, Gregg A Stevens
OBJECTIVE: Provide a systematic review of the primary literature on efforts to reduce Clostridium difficile infection (CDI) occurrence and improve outcomes in older adults. DATA SOURCES, STUDY SELECTION, DATA EXTRACTION: PubMed and CINAHL databases were searched for research studies using search terms CDI, CDI prevention, reduction, control, management, geriatric, elderly, adults 65 years of age and older. The MeSH categories Aged and Aged, 80 and older, were used...
January 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Brandon C Chapman, Hunter B Moore, Douglas M Overbey, Alex P Morton, Ben Harnke, Mark E Gerich, Jon D Vogel
BACKGROUND: Fecal microbiota transplantation (FMT) restores a diverse bacterial profile to the gastrointestinal tract and may effectively treat patients with Clostridium difficile infection (CDI). The objective of this systematic review was to evaluate the effectiveness of FMT in the treatment of CDI. METHODS: Ovid MEDLINE, EMBASE, Web of Science, and Cochrane database were used. The authors searched studies with 10 or more patients examining the resolution of symptoms after FMT in patients with CDI...
October 2016: Journal of Trauma and Acute Care Surgery
Sinan Wang, Mengque Xu, Weiqiang Wang, Xiaocang Cao, Meiyu Piao, Samiullah Khan, Fang Yan, Hailong Cao, Bangmao Wang
BACKGROUND: Fecal microbiota transplantation (FMT) is a microbiota-based therapy that shows therapeutic potential in recurrent or refractory Clostridium difficile infections and other intestinal or extra-intestinal disorders. Nonetheless, adverse events (AEs) remain a major challenge in the application of FMT. AIM: To review the AEs of FMT and to address the concerns of safety during the procedure. METHODS: Publications were retrieved in the databases of Medline, Embase and Cochrane Library...
2016: PloS One
Paul Moayyedi
PURPOSE OF REVIEW: Fecal microbiota transplant (FMT) has emerged as an important treatment for antibiotic resistant or recurrent Clostridium difficile infection. There has been a great deal of media coverage of the efficacy of FMT, and patients with inflammatory bowel disease (IBD) understandably wonder if this approach would also work for them. There are also instructions on 'do it yourself' FMT therapy on the web. It is important to understand whether there is evidence that this approach is effective in IBD so that we can advise our patients appropriately...
July 2016: Current Opinion in Gastroenterology
Shunji Fujimori
Generally, proton-pump inhibitors (PPIs) have great benefit for patients with acid related disease with less frequently occurring side effects. According to a recent report, PPIs provoke dysbiosis of the small intestinal bacterial flora, exacerbating nonsteroidal anti-inflammatory drug-induced small intestinal injury. Several meta-analyses and systematic reviews have reported that patients treated with PPIs, as well as post-gastrectomy patients, have a higher frequency of small intestinal bacterial overgrowth (SIBO) compared to patients who lack the aforementioned conditions...
June 14, 2015: World Journal of Gastroenterology: WJG
Noortje G Rossen, John K MacDonald, Elisabeth M de Vries, Geert R D'Haens, Willem M de Vos, Erwin G Zoetendal, Cyriel Y Ponsioen
AIM: To study the clinical efficacy and safety of Fecal microbiota transplantation (FMT). We systematically reviewed FMT used as clinical therapy. METHODS: We searched MEDLINE, EMBASE, the Cochrane Library and Conference proceedings from inception to July, 2013. Treatment effect of FMT was calculated as the percentage of patients who achieved clinical improvement per patient category, on an intention-to-treat basis. RESULTS: We included 45 studies; 34 on Clostridium difficile-infection (CDI), 7 on inflammatory bowel disease, 1 on metabolic syndrome, 1 on constipation, 1 on pouchitis and 1 on irritable bowel syndrome (IBS)...
May 7, 2015: World Journal of Gastroenterology: WJG
Dimitri Drekonja, Jon Reich, Selome Gezahegn, Nancy Greer, Aasma Shaukat, Roderick MacDonald, Indy Rutks, Timothy J Wilt
BACKGROUND: The role of fecal microbiota transplantation (FMT) for Clostridium difficile infection (CDI) is not well-known. PURPOSE: To assess the efficacy, comparative effectiveness, and harms of FMT for CDI. DATA SOURCES: MEDLINE (1980 to January 2015), Cochrane Library, and, followed by hand-searching references from systematic reviews and identified studies. STUDY SELECTION: Any study of FMT to treat adult patients with CDI; case reports were only used to report harms...
May 5, 2015: Annals of Internal Medicine
Natasha Bagdasarian, Krishna Rao, Preeti N Malani
IMPORTANCE: Since 2000, the incidence and severity of Clostridium difficile infection (CDI) have increased. OBJECTIVE: To review current evidence regarding best practices for the diagnosis and treatment of CDI in adults (age ≥ 18 years). EVIDENCE REVIEW: Ovid MEDLINE and Cochrane databases were searched using keywords relevant to the diagnosis and treatment of CDI in adults. Articles published between January 1978 and October 31, 2014, were selected for inclusion based on targeted keyword searches, manual review of bibliographies, and whether the article was a guideline, systematic review, or meta-analysis published within the past 10 years...
January 27, 2015: JAMA: the Journal of the American Medical Association
Gianluca Ianiro, Stefano Bibbò, Franco Scaldaferri, Antonio Gasbarrini, Giovanni Cammarota
The purpose of this article is to perform a systematic review of the literature on the use of fecal microbiota transplantation (FMT) in inflammatory bowel disease (IBD).There is an increasing interest of both physicians and patients in assessing the possible role of the FMT in the treatment of IBD.Electronic and manual bibliographic searches were performed to identify original reports in which subjects with IBD were treated with FMT. Because of the scarcity of studies with adequate sample size, case series and case reports were also considered...
October 2014: Medicine (Baltimore)
Stacy A Kahn, Sarah R Goeppinger, David T Rubin
Fecal microbiota transplantation (FMT) is a targeted microbiome-based therapy that has garnered a great deal of attention from the scientific, clinical, and lay communities. An increasing number of studies have demonstrated that FMT is a highly effective therapy for recurrent/refractory Clostridium difficile infection and appears safe in the short term. Uncontrolled reports suggest the possibility of benefit in a select group of IBD patients, but there is quite limited information so far. FMT for IBD raises significant issues and concerns that warrant further systematic investigation...
2014: Nestlé Nutrition Institute Workshop Series
Marie Céline Zanella Terrier, Martine Louis Simonet, Philippe Bichard, Jean Louis Frossard
Clostridium difficile infections (CDI) are a leading cause of antibiotic-associated and nosocomial diarrhea. Despite effective antibiotic treatments, recurrent infections are common. With the recent emergence of hypervirulent isolates of C. difficile, CDI is a growing epidemic with higher rates of recurrence, increasing severity and mortality. Fecal microbiota transplantation (FMT) is an alternative treatment for recurrent CDI. A better understanding of intestinal microbiota and its role in CDI has opened the door to this promising therapeutic approach...
June 21, 2014: World Journal of Gastroenterology: WJG
Giovanni Cammarota, Gianluca Ianiro, Antonio Gasbarrini
GOAL: By systematic review, we assessed the impact of fecal microbiota transplantation (FMT) for the treatment of Clostridium difficile (CD)-associated diarrhea. BACKGROUND: Fecal microbiota microbiota transplantation from a healthy donor into an individual with CD infection (CDI) can resolve symptoms. STUDY: We conducted systematic searches in PubMed, SCOPUS, Web of Science, and Cochrane Library. The last search was run on February 8, 2013...
September 2014: Journal of Clinical Gastroenterology
Dinesh Vyas, Heidi E L'esperance, Arpita Vyas
Fecal enemas were first reported to successfully treat life threatening enterocolitis in 1958, but fecal therapy to treat Clostridium difficile (C. difficile) infection has remained esoteric and not well investigated until recently. In the past few years, systematic reviews of case series and case reports of fecal microbiota transplant for recurrent C. difficile infection have become available and validate use of fecal transplant for C. difficile enterocolitis. Methods of fecal transplant reported in the literature include: nasogastric tube, gastroscope, duodenal tube, colonoscopy, rectal tube, and fecal enemas administered at home; no method has been shown to be superior...
August 7, 2013: World Journal of Gastroenterology: WJG
Zain Kassam, Christine H Lee, Yuhong Yuan, Richard H Hunt
OBJECTIVES: The clinical and economic burden of Clostridium difficile infection (CDI) is significant. Recurrent CDI management has emerged as a major challenge with suboptimal response to standard therapy. Fecal microbiota transplantation (FMT) has been used as a treatment to reconstitute the normal microbial homeostasis and break the cycle of antibiotic agents that may further disrupt the microbiome. Given the lack of randomized-controlled trials (RCTs) and limitations in previous systematic reviews, we aimed to conduct a systematic review with robust methods to determine the efficacy and safety profile of FMT in CDI...
April 2013: American Journal of Gastroenterology
Aijaz Ahmed Sofi, Ann Lynn Silverman, Sadik Khuder, Kjetil Garborg, Julie M A Westerink, Ali Nawras
OBJECTIVE: Clostridium difficle-associated infection (CDI) is usually treated with antibiotics; nevertheless, the infection has a high relapse rate. Case series and case reports using fecal microbiota transplant (FMT) for CDI show promising results. However, there are no large studies to provide evidence for the efficacy of this therapy. The aim of this pooled patient data meta-analysis was to determine the efficacy of FMT in CDI. METHODS: We performed a literature search for FMT for CDI or pseudomembranous colitis...
March 2013: Scandinavian Journal of Gastroenterology
Ethan Gough, Henna Shaikh, Amee R Manges
Clostridium difficile infection (CDI) is a gastrointestinal disease believed to be causally related to perturbations to the intestinal microbiota. When standard treatment has failed, intestinal microbiota transplantation (IMT) is an alternative therapy for patients with CDI. IMT involves infusing intestinal microorganisms (in a suspension of healthy donor stool) into the intestine of a sick patient to restore the microbiota. However, protocols and reported efficacy for IMT vary. We conducted a systematic literature review of IMT treatment for recurrent CDI and pseudomembranous colitis...
November 2011: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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