University of Illinois at Chicago, Chicago, IL, USA.
Edward Hines, Jr. VA Hospital, Hines, IL, USA; Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA.
Anaerobe. 2019 Dec;60:102092. doi: 10.1016/j.anaerobe.2019.102092. Epub 2019 Aug 28.
Despite lack of regulatory approval, fecal microbiota transplantation (FMT) is widely performed to manage C. difficile infection (CDI), particularly recurrent CDI. Herein, we critically review the available randomized controlled trials of FMT and address the following questions: Is FMT better than drug management of recurrent CDI?; Is FMT treatment per se or adjunctive treatment to antibiotics for CDI?; and, Is FMT safe? Finally, we elaborate non-FMT options for the management of recurrent CDI. Although promising, FMT should be reserved for patients who have failed appropriate antibiotic management of recurrent CDI.
尽管缺乏监管部门的批准,粪便微生物群移植(FMT)仍被广泛用于治疗艰难梭菌感染(CDI),尤其是复发性 CDI。在此,我们批判性地回顾了 FMT 的现有随机对照试验,并回答了以下问题:FMT 是否优于复发性 CDI 的药物管理?FMT 是治疗 CDI 的本身还是抗生素辅助治疗?FMT 是否安全?最后,我们详细介绍了复发性 CDI 的非 FMT 治疗选择。尽管 FMT 很有前途,但它应该保留给那些复发性 CDI 的适当抗生素治疗失败的患者。