Midwestern University College of Pharmacy-Glendale, Glendale, AZ.
Department of Pharmacy Services, Banner Thunderbird Medical Center, Glendale, AZ.
Am J Health Syst Pharm. 2019 Jun 18;76(13):935-942. doi: 10.1093/ajhp/zxz078.
Randomized controlled trials investigating the efficacy and safety of fecal microbiota transplantation (FMT) for recurrent Clostridioides difficile infection (CDI) are reviewed, and practical issues for pharmacists to consider are discussed.
Eight randomized controlled trials evaluating the use of FMT for recurrent CDI were analyzed. The trials varied in the type of sample (fresh, frozen, lyophilized), route of administration (nasogastric tube, colonoscopy, enema, oral), and comparator agent (different type of FMT, vancomycin). Efficacy rates ranged from 43.8% to 96.2% with FMT, and safety data were relatively similar. With these favorable data, pharmacists are likely to be involved at multiple steps in the delivery of FMT to patients with recurrent CDI, including the procurement, documentation, and administration of various products and patient education.
FMT is an option for recurrent CDI that is supported by findings of randomized controlled trials, although a preferred method for the delivery remains to be defined. Pharmacists can play an important role in the successful management of patients with recurrent CDI who may benefit from FMT.
综述了评估粪便微生物群移植（FMT）治疗复发性艰难梭菌感染（CDI）的疗效和安全性的随机对照试验，并讨论了药师需要考虑的实际问题。
分析了 8 项评估 FMT 治疗复发性 CDI 的随机对照试验。这些试验在样本类型（新鲜、冷冻、冻干）、给药途径（鼻胃管、结肠镜、灌肠、口服）和对照药物（不同类型的 FMT、万古霉素）方面存在差异。FMT 的疗效率在 43.8%至 96.2%之间，安全性数据相对相似。鉴于这些有利的数据，药剂师可能会在为复发性 CDI 患者提供 FMT 的多个步骤中发挥重要作用，包括采购、记录和管理各种产品以及患者教育。
FMT 是复发性 CDI 的一种选择，得到了随机对照试验结果的支持，尽管仍需确定其首选的给药方法。药剂师可以在成功管理可能受益于 FMT 的复发性 CDI 患者方面发挥重要作用。
