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Most cases of Clostridium difficile (CD) colitis resolve after a single course of oral metronidazole or vancomycin, but a few patients have debilitating symptoms that are refractory to repeated antibiotic courses. Case reports have suggested that orally administered normal feces can be used to restore normal bacterial stool flora, and a larger series now lends support to this treatment of last resort.
Eighteen patients (age range, 51-88) with refractory CD colitis were referred to a single Minnesotan practitioner from 1994 through 2002; they had undergone from 2 to 7 courses of metronidazole or vancomycin but still exhibited persistent symptoms and CD cytotoxin in stool samples. Stool donors (mostly family members) were screened for hepatiti…