Stool-Transplant Enema for Recurrent Clostridium difficile Infection

Patients with Clostridium difficile (CD) infection are typically given prolonged courses of metronidazole or vancomycin, high-dose or tapering regimens of vancomycin, or sequential therapy involving vancomycin followed by rifampin or rifaximin. Several reports have explored fecal transplantation for treating patients with recurrent CD infection (e.g., JW Gastroenterol Apr 29 2003).

A new case series focused on the efficacy of these “stool transplants,” self-administered via enema, in seven patients with refractory CD infection. All had been treated with 125 mg of vancomycin four times per day for 14 days, then quadruple that dose for the same duration, and then tapering regimens of vancomycin in combination with Saccharomyces boulardii admin…