Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 10 February 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Duodenal infusion of donor feces vs vancomycin for C. difficile

A study in this week's issue of the New England Journal of Medicine examines the effect of duodenal infusion of donor feces for recurrent Clostridium difficile.

News image

Recurrent Clostridium difficile infection is difficult to treat, and failure rates for antibiotic therapy are high.

Dr Els van Nood and colleagues studied the effect of duodenal infusion of donor feces in patients with recurrent C. difficile infection.
 
The research team randomly assigned patients to receive 1 of 3 therapies.

Group 1 received an initial vancomycin regimen, followed by bowel lavage and subsequent infusion of a solution of donor feces through a nasoduodenal tube.

Group 2 received a standard vancomycin regimen.

Patients in Group 3 received a standard vancomycin regimen with bowel lavage.

The primary end point was the resolution of diarrhea associated with C. difficile infection without relapse after 10 weeks.
 
The study was stopped after an interim analysis.

Of 16 patients in the infusion group, 81% had resolution of C. difficile–associated diarrhea after the first infusion.

The 3 remaining patients received a second infusion with feces from a different donor, with resolution in 2 patients.

Resolution of C. difficile infection occurred in 31% of patients receiving vancomycin alone, and in 23% of patients receiving vancomycin with bowel lavage.

No significant differences in adverse events among the 3 study groups were observed except for mild diarrhea, and abdominal cramping in the infusion group on the infusion day.

After donor-feces infusion, patients showed increased fecal bacterial diversity, similar to that in healthy donors, with an increase in Bacteroidetes species and clostridium clusters IV and XIVa, and a decrease in Proteobacteria species.
 
Dr van Nood's team concludes, "The infusion of donor feces was significantly more effective for the treatment of recurrent C. difficile infection than the use of vancomycin."

NEJM 2013; 368: 407-415
01 February 2013

Go to top of page Email this page Email this page to a colleague

 10 February 2016 
NAFLD in Veterans in the USA
 10 February 2016 
Rectosigmoidoscopy vs colonoscopy in ulcerative colitis
 10 February 2016 
Liver cancer and primary biliary cirrhosis
 09 February 2016 
Cancer-specific prognosis in octogenarians with colorectal cancer
 09 February 2016 
Eosinophilic esophagitis and parental allergies
 09 February 2016 
Bowel preparation for colonoscopy screening
 08 February 2016 
Immunity in the human gut
 08 February 2016 
Cancelled colonoscopy appointments
 08 February 2016 
Cognitive function in Crohn's disease
 05 February 2016 
Helicobacter cinaedi bacteremia
 05 February 2016 
Methotrexate and remission in ulcerative colitis
 05 February 2016 
Treatment for ileal pouch-anal anastomosis for Crohn’s colitis
 04 February 2016 
Diabetes and liver cancer
 04 February 2016 
Colorectal cancer screening
 04 February 2016 
H. pylori and coronary heart disease 
 03 February 2016 
Acute diverticulitis and IBS 
 03 February 2016 
Microbiota of the colonic mucosa and chronic constipation
 03 February 2016 
Guidelines for chronic pancreatitis
 02 February 2016 
Ramosetron and IBS-diarrhea
 02 February 2016 
IBD emergency department visits
 02 February 2016 
Probiotics for H. pylori management
 01 February 2016 
Depressive symptoms in IBD 
 01 February 2016 
Obesity and hepatocellular carcinoma risk
 01 February 2016 
Managing HBV in pregnancy
 29 January 2016 
Colorectal cancer after colonoscopy
 29 January 2016 
Acute diverticulitis in immunosuppressed patients
 29 January 2016 
Vitamin D and colorectal cancer risk
 28 January 2016 
Tissue anti-TNF drug levels and IBD
 28 January 2016 
First line treatment of H. pylori infection
 28 January 2016 
Tetracycline for rosacea increases the risk of IBD
 27 January 2016 
Steroids in children with Crohn's
 27 January 2016 
Self-management IBS program 
 27 January 2016 
Human gut microbiome in IBD 
 26 January 2016 
Smoking and symptomatic diverticular disease
 26 January 2016 
Step-down therapy in PPI-responsive esophageal eosinophilia 
 26 January 2016 
Diet and IBD risk
 25 January 2016 
IBD monitoring using smartphones
 25 January 2016 
Self-management IBS program
 25 January 2016 
Colorectal cancer after a negative screening sigmoidoscopy
 22 January 2016 
Length of Barrett's and cancer
 22 January 2016 
Psychosocial interventions and alcohol abstinence in chronic liver disease
 22 January 2016 
Helicobacter pylori antibiotic resistance
 21 January 2016 
Increasing adenoma detection rate during colonoscope withdrawal
 21 January 2016 
Microscopic colitis current concepts
 21 January 2016 
Statins as a management strategy for constipation 
 20 January 2016 
Health status after bariatric surgery
 20 January 2016 
Hep E infection in West Africa
 20 January 2016 
Preventing endoscopic bacterial transmission
 19 January 2016 
PPIs and phlebotomy in hereditary hemochromatosis
 19 January 2016 
Predicting liver cirrhosis in Hep C
 19 January 2016 
Frozen vs fresh fecal microbiota transplantation
 18 January 2016 
Hospitalization for diverticulitis in the USA
 18 January 2016 
H. pylori and gastric cancer across Europe
 18 January 2016 
Enteral nutrition in children with Crohn's
 15 January 2016 
Alcohol- and HCV-related hepatocellular carcinoma
 15 January 2016 
Recurrent colonic diverticulitis
 15 January 2016 
Colonic diverticula and colorectal cancer risk
 14 January 2016 
Risk stratification of incidentally discovered gallstones
 14 January 2016 
Treatment of refractory cholestatic pruritus
 14 January 2016 
Colonic diverticula and colorectal cancer risk 

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us