Stool Transplants May be More Effective Than Antibiotics for Treating Severe Gut Infections

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New research suggests that patients with certain gut conditions may have better health outcomes when treated with fecal microbiota transplantation than antibiotic interventions.

Two review articles published in the Cochrane Database of Systemic Reviews support the findings. Both studies were led by Aamer Imdad, MBBS, assistant professor of pediatrics at Upstate University Hospital in Syracuse, New York.

For the first review, Imdad and his team of researchers examined data from six clinical trials that assessed the efficacy and safety of stool transplantation in patients with repeated Clostridioides difficile (C. diff) infection, a condition that can lead to life-threatening diarrhea.

“After a person with a C. diff infection gets treated with antibiotics, there is about a 25 percent chance that they will have another episode of C. diff infection in the next eight weeks,” Imdad said in a statement. “The risk of recurrence increases to about 40 percent with the second episode and to nearly 60 percent with the third episode. So, once you are in this cycle, it gets more and more difficult to break out of it. Stool transplants can reverse the dysbiosis and thus decrease the risk of recurrence of the disease.”  

The investigations were conducted in various countries, including Denmark, the Netherlands, Italy, Canada, and the United States, and together included 320 participants. Most of the studies compared the fecal transplant intervention to a standard vancomycin antibiotic treatment.

After analyzing the data from each study, researchers found that the stool transplantation led to a larger increase in the resolution of repeated C. diff infections and a decrease in side effects compared to the antibiotic intervention.

Imdad’s second review analyzed data from investigations on stool transplantation to treat inflammatory bowel disease (IBD). The studies focused on the two primary forms of IBD, ulcerative colitis and Crohn's disease.

According to the researchers, the review indicated promising results for fecal transplantation for the treatment of ulcerative colitis, but they were not entirely conclusive. For Crohn's disease, the results were less conclusive.

Although stool transplants appear promising for treating certain gut conditions, particularly reoccurring C. diff infections, researchers said more research is needed to determine the intervention's safety and short and long-term risks.