Are antibiotics failing you in the fight against gut infections? New treatment offers relief for life-threatening Gut Infections
A recent Cochrane Review conducted by a professor from Upstate Medical University has revealed that stool transplants are more effective than antibiotics in treating recurring, life-threatening gut infections caused by Clostridioides difficile (C. diff).
The review found that 77% of patients who received a stool transplant did not experience reinfection within eight weeks, whereas only 40% of those treated with antibiotics alone avoided reinfection.
These findings suggest that stool transplantation could be a highly promising alternative to antibiotic treatment for individuals with C. diff infections.
C. diff is a type of bacteria that has the potential to cause life-threatening diarrhea in people whose gut contains an imbalanced mixture of bacteria, a condition known as dysbiosis. The primary cause of dysbiosis is the use of antibiotics, which are effective in treating bacterial infections, but also have the ability to harm the beneficial bacteria present in the gut, collectively referred to as the intestinal microbiome. Typically, the gut’s population of “good” bacteria recovers rapidly, but on occasion, “bad” species like C. diff can proliferate and lead to severe diarrhea.
C. diff infection is typically treated with antibiotics, but this approach can worsen the imbalance of gut microbes, known as dysbiosis, and perpetuate a cycle of short-lived treatment effects followed by recurrent infections. Unfortunately, this cycle occurs in nearly one-third of infected individuals. According to the Centers for Disease Control and Prevention (CDC), each year in the United States alone, there are approximately 250,000 cases of C. diff infection, resulting in roughly 12,000 deaths.
The process of transplanting healthy stool from a donor into a gut with dysbiosis aims to restore a healthy microbiome and balance gut microbes, which can greatly reduce the risk of C. diff recurring. This process operates in a similar way to blood donation, where donors are thoroughly screened for any diseases or infections before their stool can be used. Stool transplantation can be performed through various methods including colonoscopy, nasogastric or nasoduodenal tube, enema, or by taking a capsule. Recently, the US Food and Drug Administration has approved a stool transplant product that can be administered as an enema, specifically designed to prevent the recurrence of C. diff.
The new Cochrane Review, helmed by pediatric gastroenterologist Aamer Imdad MBBS, analyzed data from six clinical trials involving 320 adults, to evaluate the effectiveness and safety of stool transplantation as a treatment for recurrent C. diff infection. The studies were conducted in Denmark (two), the Netherlands, Italy, Canada, and the United States (one each). Most of the trials compared stool transplantation with the standard antibiotic therapy using vancomycin, which is frequently prescribed for this type of infection.
According to the review, stool transplantation results in a greater improvement in resolving recurrent C. diff infections compared to other treatments examined. Moreover, this treatment approach has fewer side effects in comparison to the standard antibiotic treatment.
Imdad explains that individuals treated with antibiotics for a C. diff infection face a 25% chance of experiencing another episode within 8 weeks. The risk of recurrence increases to 40% with a second episode and almost 60% with a third episode, making it progressively challenging to break out of this cycle. However, stool transplants offer a promising solution by restoring the microbiome’s balance and reducing the likelihood of disease recurrence.
“Stool transplants can reverse the dysbiosis and thus decrease the risk of recurrence of the disease.”
A follow-up Cochrane Review, led by Dr. Imdad, examined the potential of stool transplants in treating inflammatory bowel disease (IBD), a term that encompasses ulcerative colitis and Crohn’s disease. While the review demonstrated encouraging outcomes for the treatment of ulcerative colitis, the data is not yet definitive.
For Crohn’s disease, the results are even more uncertain, indicating the need for further research before stool transplants can be recognized as a viable treatment option for IBD.
The findings of the study were published in the Cochrane Database of Systematic Reviews.
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