The first multi-center, long-term study of the effectiveness of fecal microbiota transplant to treat recurrent C. difficile infections showed an overall cure rate of 98 percent, according to an Infectious Disease Special Edition report.
The procedure involves transplanting a stool sample from a healthy donor to treat C. difficile. One-quarter of patients who contract a C. difficile infection will have a recurrence, and those who do have a recurrence have a 40-50 percent change of multiple recurrences.
The study looked at 77 patient had undergone colonoscopic FMT at least three months prior to the study and at five different medical centers. The patients had an average age of 65 years, ranging from 22 to 87 years. Average duration of illness was 11 months, and patients had undergone an average of five treatment courses for C. difficile. Of the donors, 46 were spouses or partners, 19 were first-degree relatives, nine were friends, two were other relatives and one donor was unknown to the patient. More than 70 percent of the donors lived in the same household as the patient.
After the first treatment, 91 percent of the patients had no recurrence of diarrhea within 90 days. Of the seven who were not cured by the initial treatment, four responded to a single two-week course of an antibiotic and two responded to a second FMT. This led to a secondary cure rate of 98 percent. The one remaining patient was in hospice care and was not retreated.
Despite the procedure's high effectiveness rate, it is not widely accepted and insurance providers do not cover the actual procedure. Physicians can get reimbursed for the colonoscopy, but the pretesting, which includes testing patients and donors for hepatitis A, B and C; HIV; syphilis; parasites and C. difficile toxin, costs more than $700 and is not covered.
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The procedure involves transplanting a stool sample from a healthy donor to treat C. difficile. One-quarter of patients who contract a C. difficile infection will have a recurrence, and those who do have a recurrence have a 40-50 percent change of multiple recurrences.
The study looked at 77 patient had undergone colonoscopic FMT at least three months prior to the study and at five different medical centers. The patients had an average age of 65 years, ranging from 22 to 87 years. Average duration of illness was 11 months, and patients had undergone an average of five treatment courses for C. difficile. Of the donors, 46 were spouses or partners, 19 were first-degree relatives, nine were friends, two were other relatives and one donor was unknown to the patient. More than 70 percent of the donors lived in the same household as the patient.
After the first treatment, 91 percent of the patients had no recurrence of diarrhea within 90 days. Of the seven who were not cured by the initial treatment, four responded to a single two-week course of an antibiotic and two responded to a second FMT. This led to a secondary cure rate of 98 percent. The one remaining patient was in hospice care and was not retreated.
Despite the procedure's high effectiveness rate, it is not widely accepted and insurance providers do not cover the actual procedure. Physicians can get reimbursed for the colonoscopy, but the pretesting, which includes testing patients and donors for hepatitis A, B and C; HIV; syphilis; parasites and C. difficile toxin, costs more than $700 and is not covered.
Related Articles on Fecal Transplant:
Dr. Tim Rubin Featured on Medical Show for Fecal Transplant Procedure
Commentary: Fecal Transplants Work, the Regulations Don't
Fecal Transplants Gaining Popularity