Fecal microbiota transplantation or transfer aims at replacing or reinforcing the gut microbiota of a patient with the microbiota from a healthy donor.
Not many controlled or randomized studies have been published evaluating the use of fecal microbiota transplantation for other diseases than Clostridium difficile infection, making it difficult for clinicians to decide on a suitable indication.
Dr König and colleagues from Sweden provided an expert consensus on current clinical indications, applications and methodological aspects of fecal microbiota transplantation.
The team accessed well-acknowledged experts from various countries in Europe to contribute to this article.
After literature review, consensus has been achieved by repetitive circulation of the statements and the full manuscript among all authors with intermittent adaptation to comments.
|Consensus was defined a priori as agreement by at least 75% of the authors|
|Alimentary Pharmacology & Therapeutics|
The researchers rated levels of evidence and agreement according to the GRADE system.
Consensus was defined a priori as agreement by at least 75% of the authors.
The team's key recommendations included the use of fecal microbiota transplantation in recurrent Clostridium difficile infection characterized by at least 2 previous standard treatments without persistent cure.
The research team also considered severe and severe-complicated Clostridium difficile infection as an alternative to total colectomy in case of early failure of antimicrobial therapy.
Fecal microbiota transplantation in inflammatory bowel diseases (IBD), irritable bowel syndrome (IBS) and metabolic syndrome should only be performed in research settings.
Dr König's team concludes, "Fecal microbiota transplantation or transfer is a promising treatment for a variety of diseases in which the intestinal microbiota is disturbed."
"For indications other than Clostridium difficile infection, more evidence is needed before more concrete recommendations can be made."