Comparing fecal microbiota transplantation to standard-of-care treatment for recurrent Clostridium difficile infection: a systematic review and meta-analysis

Khan, Muhammad Yasir; Dirweesh, Ahmed; Khurshid, Talal; Siddiqui, Waqas Javed

doi:10.1097/meg.0000000000001243

Cited by 49 publications

(30 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…FMT is a highly efficacious treatment of recurrent CDI with significantly increased rates of clinical and microbiological 'cure' after FMT when compared with antibiotic therapy, autologous FMT or placebo, with overall success rates >85% 1–12 101–105…”

Section: Resultsmentioning

confidence: 99%

Australian consensus statements for the regulation, production and use of faecal microbiota transplantation in clinical practice

Haifer

Kelly

Paramsothy

et al. 2020

Gut

View full text Add to dashboard Cite

ObjectiveFaecal microbiota transplantation (FMT) has proved to be an extremely effective treatment for recurrent Clostridioides difficile infection, and there is interest in its potential application in other gastrointestinal and systemic diseases. However, the recent death and episode of septicaemia following FMT highlights the need for further appraisal and guidelines on donor evaluation, production standards, treatment facilities and acceptable clinical indications.DesignFor these consensus statements, a 24-member multidisciplinary working group voted online and then convened in-person, using a modified Delphi approach to formulate and refine a series of recommendations based on best evidence and expert opinion. Invitations to participate were directed to Australian experts, with an international delegate assisting the development. The following issues regarding the use of FMT in clinical practice were addressed: donor selection and screening, clinical indications, requirements of FMT centres and future directions. Evidence was rated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system.ResultsConsensus was reached on 27 statements to provide guidance on best practice in FMT. These include: (1) minimum standards for donor screening with recommended clinical selection criteria, blood and stool testing; (2) accepted routes of administration; (3) clinical indications; (4) minimum standards for FMT production and requirements for treatment facilities acknowledging distinction between single-site centres (eg, hospital-based) and stool banks; and (5) recommendations on future research and product development.ConclusionsThese FMT consensus statements provide comprehensive recommendations around the production and use of FMT in clinical practice with relevance to clinicians, researchers and policy makers.

show abstract

Section: Resultsmentioning

confidence: 99%

Australian consensus statements for the regulation, production and use of faecal microbiota transplantation in clinical practice

Haifer

Kelly

Paramsothy

et al. 2020

Gut

View full text Add to dashboard Cite

show abstract

“…121 FMT has been used to treat recurrent Clostridium difficile infection (CDI). 122 However, the mode of action and effect of FMT in UC remains unclear, and additional studies are needed to overcome several challenges for improving the clinical application of FMT. 9…”

Section: Therapeutic Strategy Of Fmt In Uc and Controversymentioning

confidence: 99%

Gut microbiota in ulcerative colitis: insights on pathogenesis and treatment

Guo

Liu

Hao

2020

J of Digest Diseases

137

View full text Add to dashboard Cite

Gut microbiota constitute the largest reservoir of the human microbiome and are an abundant and stable ecosystem—based on its diversity, complexity, redundancy, and host interactions This ecosystem is indispensable for human development and health. The integrity of the intestinal mucosal barrier depends on its interactions with gut microbiota. The commensal bacterial community is implicated in the pathogenesis of inflammatory bowel disease (IBD), including ulcerative colitis (UC). The dysbiosis of microbes is characterized by reduced biodiversity, abnormal composition of gut microbiota, altered spatial distribution, as well as interactions among microbiota, between different strains of microbiota, and with the host. The defects in microecology, with the related metabolic pathways and molecular mechanisms, play a critical role in the innate immunity of the intestinal mucosa in UC. Fecal microbiota transplantation (FMT) has been used to treat many diseases related to gut microbiota, with the most promising outcome reported in antibiotic‐associated diarrhea, followed by IBD. This review evaluated the results of various reports of FMT in UC. The efficacy of FMT remains highly controversial, and needs to be regularized by integrated management, standardization of procedures, and individualization of treatment.

show abstract

“…Fecal microbiota transplantation has long been used to treat recurrent Clostridium difficile infection (CDI) presenting great effectiveness and significant safeness, with cure rates reaching 90% (Khan et al, 2018). One of the main mechanisms proposed to explain the ability of FMT to treat CDI is attributed to its capacity to restore intestinal microbial balance (Gagliardi et al, 2018).…”

Section: Fecal Microbiota Transplantation (Fmt)mentioning

confidence: 99%

Microbial-Based Therapies in the Treatment of Inflammatory Bowel Disease – An Overview of Human Studies

2019

View full text Add to dashboard Cite

Inflammatory bowel disease (IBD) is a group of multifactorial and inflammatory infirmities comprised of two main entities: Ulcerative colitis (UC) and Crohn’s disease (CD). Classic strategies to treat IBD are focused on decreasing inflammation besides inducing and extending disease remission. However, these approaches have several limitations such as low responsiveness, excessive immunosuppression, and refractoriness. Despite the multifactorial causality of IBD, immune disturbances and intestinal dysbiosis have been suggested as the central players in disease pathogenesis. Hence, therapies aiming at modulating intestinal microbial composition may represent a promising strategy in IBD control. Fecal microbiota transplantation (FMT) and probiotics have been explored as promising candidates to reestablish microbial balance in several immune-mediated diseases such as IBD. These microbial-based therapies have demonstrated the ability to reduce both the dysbiotic environment and production of inflammatory mediators, thus inducing remission, especially in UC. Despite these promising results, there is still no consensus on the relevance of such treatments in IBD as a potential clinical strategy. Thus, this review aims to critically review and describe the use of FMT and probiotics to treat patients with IBD.

show abstract

Comparing fecal microbiota transplantation to standard-of-care treatment for recurrent Clostridium difficile infection: a systematic review and meta-analysis

Abstract: FMT is a promising treatment modality for rCDI compared with MT alone. Different forms and routes of FMT administration seem to be equally efficacious. In future, more well-designed RCTs directed at homogenous FMT preparation and delivery methods are required to validate these findings.

Cited by 49 publications

References 41 publications

Australian consensus statements for the regulation, production and use of faecal microbiota transplantation in clinical practice

Australian consensus statements for the regulation, production and use of faecal microbiota transplantation in clinical practice

Gut microbiota in ulcerative colitis: insights on pathogenesis and treatment

Microbial-Based Therapies in the Treatment of Inflammatory Bowel Disease – An Overview of Human Studies

Contact Info

Product

Resources

About