Fecal Transplantation vs. Tapered Vancomycin for Clostridium difficile Infection: Is One Better?

In a small randomized, controlled trial, disease recurred in 56% of patients after fecal transplantation and 42% after tapered vancomycin.

Of patients with Clostridium difficile infection, 20% to 47% develop recurrent infection (RCDI). Treatments for RCDI include oral vancomycin (OV), given in a tapering regimen over 4 to 6 weeks, and fecal transplantation (FT), in which feces from a healthy donor is introduced into the gastrointestinal tract of the patient. Five previous trials of FT had success rates of 70% to 94%, but none of these included a comparison to OV.

In the present study, 30 patients with RCDI who received 14 days of OV were then randomized to either FT by enema using feces from healthy donors or OV at a tapering and pulsed dose over 4 weeks. Subjects were then followed for 120 days for recurrence. Nine of 16 FT recipients (56%) developed recurrence. Two of 14 pate…

Reviewing Author

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Fecal Transplantation vs. Tapered Vancomycin for Clostridium difficile Infection: Is One Better?

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Reviewing Author