• World J. Gastroenterol. · Jun 2014

    Review

    Recurrent Clostridium difficile infections: the importance of the intestinal microbiota.

    • Marie Céline Zanella Terrier, Martine Louis Simonet, Philippe Bichard, and Jean Louis Frossard.
    • Marie Céline Zanella Terrier, Martine Louis Simonet, Service of General Internal Medicine, Geneva University Hospital, 1211 Geneva, Switzerland.
    • World J. Gastroenterol. 2014 Jun 21;20(23):7416-23.

    AbstractClostridium 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. FMT is thought to resolve dysbiosis by restoring gut microbiota diversity thereby breaking the cycle of recurrent CDI. Since the first reported use of FMT for recurrent CDI in 1958, systematic reviews of case series and case report have shown its effectiveness with high resolution rates compared to standard antibiotic treatment. This article focuses on current guidelines for CDI treatment, the role of intestinal microbiota in CDI recurrence and current evidence about FMT efficacy, adverse effects and acceptability.

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