A Systematic Review on Fecal Microbiota Transplant in Recurrent Clostridium Difficile Infections

This chapter assess the efficacy and safety of FMT in RCDI patients and compare it with control groups. The term ‘microbiota’ refers to the bacteria, archaea, microeukaryotes, and viruses that share the human body space, and these microorganisms may function in a commensal, symbiotic, or pathogenic relationship. Fecal microbiota transplantation (FMT) is the administration of a solution of fecal matter from a donor into the intestinal tract of a recipient in order to directly change the recipient’s microbial composition and confer a health benefit.

Using automation tools, the online databases PubMed, PubMed Central, Science Direct, Google Scholar, and Embase were searched for pertinent publications published in the previous five years (from 2016 to 2021). After removing duplicate entries, two authors independently reviewed eligibility requirements, titles, and abstracts before rating the quality.

We obtained a total of 1161 articles after searching five online databases. All the duplicates then were removed, titles and abstracts, full texts screened, and a total of 40 articles were reviewed. Most studies in this review suggest FMT is effective in patients with multiple recurrences with an efficacy range (68% to 100%). Moreover, in RCDI groups with three or more recurrences, FMT is clearly beneficial. This benefit of FMT has been well established in a cohort study consisting of 113 RCDI patients, of which 77 patients with three or more recurrences were in the FMT (n=52) and non-FMT (n=25) groups. The study showed statistically no significant differences in the incidence of allergic diseases and prevalence of diseases like IBD, cancer, autoimmune diseases, and neurological diseases (migraine and dementia), rather there was a statistically significant improvement in bowel functions between the groups, respectively (p=.016).

The use of faecal microbiota transplantation to treat persistent Clostridium difficile infections has proven to be efficient and secure. Since their effectiveness and safety have only been shown in a small number of pragmatic trials, their applicability is not well established. In order to thoroughly prove its efficiency and safety in the treatment of recurrent Clostridium difficile infection, robust investigations, both observation and experiment, are required in the future.