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Objective: To determine the effectiveness of fecal microbiota transplant in addition to traditional therapy of oral vancomycin for the treatment of recurrent Clostridium difficile infections. Methods: Google Scholar was searched to identify randomized control trials using the terms vancomycin, fecal transplant, c. diff, and recurrent. Results: Three studies met inclusion criteria and two found a statistically significant benefit to the addition of fecal microbiota transplant to vancomycin therapy. Cammarota, et al. reported a 90% cure rate when administering fecal microbiota transplant in addition to vancomycin as opposed to a 26% cure rate with vancomycin alone with a P value of 0.0001.3 Hvas, et al. found a 71% clearance rate with dual therapy and 19% cure rate with antibiotics alone at a P value of 0.001.4 Hota, et al. showed that only 43.8% of patients had clearance with a 56.2% recurrence rate.5 Conclusion: This review offered conflicting evidence in regards to the efficacy of fecal microbiota transplants in reducing Clostridium difficile recurrence. Differing variables including study location, administration route, antibiotic duration, and follow up period doesn’t allow for a definitive recommendation at this time. Further research using larger sample sizes and congruent vancomycin regimens are crucial to better evaluate this intervention.
Afflick A, LaBoue J. Efficacy of fecal microbiota transplant in conjunction with oral vancomycin for the treatment of recurrent Clostridium difficile. Posted online December 14, 2020.