Fecal microbial transplantation (FMT) may be beneficial for a patient with refractory Clostridium difficile disease. The goal is to use a normal bowel flora to replace an altered flora supportive of Clostridium difficile.
Synonyms: stool transplant, fecal bacteriotherapy
In theory refractory Clostridium difficile may occur secondary to a change in the normal bowel flora caused by antibiotics or comorbid conditions. Introduction of "normal" bowel flora may restore an environment where Clostridium difficile will not florish.
FMT may be considered in a patient with refractory Clostridium difficile, with 2 or more episodes despite optimal medical management. The procedure usually has been tried in patients with symptoms lasting several months and with a history of multiple antibiotic courses for C. difficile.
Most patients who receive FMT respond to therapy. Patients who do not respond to the first course of FMT will respond to a second course, with or without a preceding course of vancomycin.
A patient who undergoes FMT may have a recurrence of C. difficile disease if s/he undergoes antibiotic therapy later.
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