Duodenal Infusion of Donor Feces for Recurrent Clostridium difficile

E. van Nood, A. Vrieze, M. Nieuwdorp, S. Fuentes Enriquez de Salamanca, E.G. Zoetendal, W.M. de Vos, C.E. Visser, E.J. Kuijper, J.F. Bartelsman, J.G. Tijssen, P. Speelman, M.G. Dijkgraaf, J.J. Keller

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Abstract

Background Recurrent Clostridium difficile infection is difficult to treat, and failure rates for antibiotic therapy are high. We studied the effect of duodenal infusion of donor feces in patients with recurrent C. difficile infection. Methods We randomly assigned patients to receive one of three therapies: an initial vancomycin regimen (500 mg orally four times per day for 4 days), followed by bowel lavage and subsequent infusion of a solution of donor feces through a nasoduodenal tube; a standard vancomycin regimen (500 mg orally four times per day for 14 days); or a standard vancomycin regimen with bowel lavage. The primary end point was the resolution of diarrhea associated with C. difficile infection without relapse after 10 weeks. Results The study was stopped after an interim analysis. Of 16 patients in the infusion group, 13 (81%) had resolution of C. difficile-associated diarrhea after the first infusion. The 3 remaining patients received a second infusion with feces from a different donor, with resolution in 2 patients. Resolution of C. difficile infection occurred in 4 of 13 patients (31%) receiving vancomycin alone and in 3 of 13 patients (23%) receiving vancomycin with bowel lavage (P
Original languageEnglish
Pages (from-to)407-415
JournalNew England Journal of Medicine
Volume368
Issue number5
DOIs
Publication statusPublished - 2013

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Keywords

  • intestinal microbiota
  • fecal bacteriotherapy
  • infection
  • disease
  • diarrhea
  • colitis
  • vancomycin
  • antibody
  • protection
  • diversity

Cite this

van Nood, E., Vrieze, A., Nieuwdorp, M., Fuentes Enriquez de Salamanca, S., Zoetendal, E. G., de Vos, W. M., ... Keller, J. J. (2013). Duodenal Infusion of Donor Feces for Recurrent Clostridium difficile. New England Journal of Medicine, 368(5), 407-415. https://doi.org/10.1056/NEJMoa1205037