Diarrhea, recurrent after antibiotics; it may be a transplant, fecal oral
Published the 04.12.2017 at 0725 hrs
colitis infectieuseantibiotiqueClostridium difficilegreffe fecal
In adults with infectious colitis recurrent Clostridium difficile, transplant fecal by means of oral capsules is also effective as the graft through the colonoscopy to prevent recurrence. The results at 12 weeks for evaluation are published in JAMA.
In this study randomized non-inferiority on 116 adults with infectious colitis, post-antibiotic recurrent Clostridium difficile, the proportion of patients recurrence-free at 12 weeks is 96.2% after a single treatment in the group transplanted by capsules and treated by colonoscopy, respecting the margin of non-inferiority pre-specified 15%.
The oral route has many advantages
The frequency of minor adverse drug events was 5.4% in the group of transplantation per capsule compared to 12.5% in the group of transplantation by colonoscopy. There was no significant difference between the groups for the improvement of the quality of life and the 2 routes of administration are thus equivalent in terms of efficacy and tolerance.
A significantly higher proportion of patients transplanted by capsules rated their experience from “not at all unpleasant” compared to the transplantation by colonoscopy (66% vs 44%, difference 22% [95% CI, 3% -40%], p = 0.01).
An infection is recurrent and difficult to treat
Infection with Clostridium difficile is the leading cause of infectious diarrhea after an antibiotic treatment. The first-line treatment for this infection is antibiotic treatment, but 10% to 30% of patients will experience a recurrence. The risk of recidivism is approaching 60% after the third treatment.
In this case, the transplantation of fecal is the most effective treatment against infectious colitis recurrent Clostridium difficile. According to the studies, its effectiveness varies between 60% and 90% after a single attempt of the registry. The mode of administration considered to be the most effective for the prevention of recurrence is the administration by colonoscopy (90%), followed by the gastrointestinal track higher (80%), but it is on the basis of studies that were not controlled.
The transplantation of fecal microbiota intestinal tract by using a capsule by the oral route is as effective as endoscopic to prevent the recurrence of infectious colitis Clostridium difficile. However, it is better not to bite into the capsule when swallowed.