FRIDAY, Jan. 13, 2017 (HealthDay News) — A single fecal transplant delivered by enema is apparently no more effective than oral antibiotics in treating recurring cases of a nasty stomach bug, a Canadian study contends.
The study is the first head-to-head comparison between fecal transplant and the current standard of care of antibiotics in treating Clostridium difficile infection, the researchers said.
“We thought it was important to have that comparison so we could know: How much better is it than what we’re actually already doing?” said lead author Dr. Susy Hota. She’s the medical director of infection prevention and control at University Health Network in Toronto.
In this study, “it looks like they’re working about the same,” Hota said. “In half the patients, it didn’t work, but in the other half, it did.”
Infection from C. difficile bacteria can be debilitating, triggering bouts of diarrhea and other intestinal symptoms.
It often occurs in hospitals and nursing homes among people on antibiotics, especially older adults, according to the U.S. Centers for Disease Control and Prevention.
Antibiotics can destroy the gut’s good bacteria, allowing the bug to multiply, the researchers said.
Introducing stool from a healthy donor into the bowel of a patient with C. difficile infection is believed to restore the gut’s natural mix of microbes (known as microbiota).
Traditionally, doctors prescribe another antibiotic — oral vancomycin — to treat C. difficile. But infections treated with antibiotics recur in about 20 percent of patients, the CDC says.
Recent studies suggest fecal transplant may be an effective way to stop the cycle of infection.
Dr. Colleen Kelly, who wasn’t involved in the new study, is an assistant professor of medicine at Brown University’s Alpert School of Medicine in Providence, R.I.
“The results from this study differ from our clinical experience, in which FMT [fecal microbiota transplantation] is effective for 85 to 90 percent of patients treated,” Kelly said.
One reason may be the method of administration — the Canadian study used a single dose by enema. Delivery by colonoscopy “appears more effective,” Kelly said.