Blog | Thursday, October 3, 2013

QD: News Every Day--Pill offers easier route for fecal transplants for C. diff

Pills containing a concentrate of fecal bacteria successfully stopped recurrent bouts of Clostridium difficile infection, a study found.

Results were presented in a press conference at the IDWeek 2013 meeting.

Researchers reported a 100% success rate among the 27 patients who used the pills, even though all of them previously had had at least four bouts of the infection. Oral administration involved between 24 and 34 capsules containing fecal bacteria, often donated by family members.

Researchers processed the feces until it contained only bacteria, and then encapsulated the bacterial concentrate inside three layers of gelatin capsule. Researchers noted that this route may offer a potential advantage over other methods because it covers more of the GI tract, does not involve invasive and more costly procedures, and is more comfortable for patients.

The lead author noted that he first made pills for fecal transplantation when one patient failed to respond to the enema method on two occasions and also could not tolerate a nasal tube for medical reasons.

Patients satisfied with fecal transplant outcomes

Other researchers reported at the meeting that they surveyed 28 patients three months after they had undergone nasogastric fecal transplants. On a scale of one to 10, average patient scores were: 9.6 for overall satisfaction; 9.9 for ease; and 9.9 for likelihood of recommending the procedure to a family member or friend.

“Patients with C. diff often have 20 or more stools a day, which seriously affects quality of life and so they are very open to this treatment,” said Ravi Kamepalli, MBBS, ACP Member, an infectious diseases physician at the Regional Infectious Disease-Infusion Center, Lima, Ohio, and lead author of the study. “Human beings are 90% bacteria and once that balance is altered with antibiotics, opportunistic infections can cause serious problems. All we are doing with this treatment is resetting the balance.”

Dr. Kamepalli said he has treated 40 patients with recurrent C. difficile using fecal transplantation, and all but one were cured.