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Fecal microbiota transplant for refractory or recurrent Clostridium difficile infection in adults |
HAYES, Inc. |
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Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc.. Fecal microbiota transplant for refractory or recurrent Clostridium difficile infection in adults. Lansdale: HAYES, Inc.. Healthcare Technology Brief Publication. 2016 Authors' objectives Exposure to broad-spectrum antibiotics remains the greatest risk factor for Clostridium difficile infection (CDI), with some evidence suggesting that there is 8 to 10 times increased risk during and for 1 month after usage and 3 times increased risk for the next 2 months. Other risk factors for CDI include older age, gastrointestinal (GI) surgery, nasogastric tube feeding, reduced gastric acid, concurrent disease, use of immune suppressants, chronic dialysis, and residence in long-term care facilities. These factors, particularly antibiotics, cause disruption of the normal gut microbiota, or dysbiosis, thus enabling colonization of the GI tract by Clostridium difficile. Given the challenges in managing recurrent CDI, including increased risk of severe complications (e.g., septic shock, perforation), a number of experimental treatment options have been explored.
Description of Technology: Fecal microbiota transplantation (FMT), a nonpharmacological approach to treat
refractory or recurrent CDI, refers to a process in which stool obtained from a healthy donor is instilled into the GI tract of a patient with CDI. The aim is to recreate a normal and functional intestinal microbiota that will reestablish resistance to a subsequent pathogenic colonization. FMT may be delivered into the upper or lower GI tract via colonoscope, nasoduodenal or nasogastric tube, flexible sigmoidoscope, or rectal retention enema.
Patient Population: FMT is used to treat adult patients (aged >= 18 years) with recurrent CDI or CDI that is refractory to standard courses of metronidazole and vancomycin. Clinical Alternatives: Metronidazole and vancomycin comprise the standard treatments for CDI, including recurrent CDI. Fidaxomicin has received Food and Drug Administration marketing approval for the treatment of diarrhea associated with Clostridium difficile. Alternatives under investigation include rifamixin; intravenous immunoglobulin; vaccination against
Toxin A and B; and antitoxin vaccine. Indexing Status Subject indexing assigned by CRD MeSH Adult; Clostridium Infections; Clostridium difficile; Enterocolitis, Pseudomembranous; Fecal Microbiota Transplantation; Humans; Microbiota Language Published English Country of organisation United States English summary An English language summary is available. Address for correspondence HAYES, Inc., 157 S. Broad Street, Suite 200, Lansdale, PA 19446, USA. Tel: 215 855 0615; Fax: 215 855 5218 Email: hayesinfo@hayesinc.com AccessionNumber 32017000036 Date abstract record published 04/01/2017 |
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