#9: C diff, and fecal transplants

Treat C. diff, choose the correct antibiotic regimen, and identify who needs fecal transplant as we “curbside” Gastroenterologist, Dr. Adam Ehrlich from Temple University Hospital. On the show, we cover the ins-and-outs of procuring, preparing and performing transplants as well as future directions in this burgeoning field e.g. IBD, obesity, metabolic syndrome and more.

Take Home Points:

1. Clostridium difficile infection is the only indication for which FMT is allowed by the FDA without special authorization
2. FMT is VERY effective in these C difficile patients compared to standard of care (approximately 90% cure vs 30%)
3. We are just beginning to understand the role of the microbiome in human health, and I anticipate many changes in the years ahead where modifying the microbiome will be used to help treat a number of diseases.

 Links from the Show:

Recommended reading...

NEJM Journal Watch for Gastroenterology - register here

Review on novel uses for fecal transplantation

Rossen NG, et al. Fecal microbiota transplantation as novel therapy in gastroenterology: A systematic review. World J Gastroenterol. 2015 May 7;21(17):5359-71. doi: 10.3748/wjg.v21.i17.5359.

Randomized controlled trial of fresh vs frozen fecal transplantation

Fresh vs Frozen Fecal Microbiota Transplant for C diff Recurrent C difficile infection. JAMA 2016

Review on mechanisms for gut microbiota on metabolic syndromes

Qian LL, et al. Effect of the Gut Microbiota on Obesity and Its Underlying Mechanisms: an Update. Biomed Environ Sci. 2015 Nov;28(11):839-47. doi: 10.3967/bes2015.117.