Recurrent C. difficile infection is an increasingly common clinical challenge, with a number of patients unable to clear their infection, despite multiple courses of conventional or standard therapies. In the last decade, the incidence of C.-diff-associated disease has increased several folds, and the problem has been compounded further by the emergence of newer, more virulent strains leading to more severe disease and increasing rates of fatality.
The efficacy of fecal transplant in the treatment of recurrent C. diff has been documented since 1958, and in 2004 the review of 17 reports showed a 92-percent success rate of patients who underwent fecal transplant. Even though the number of studies is limited, recent reports of high success rates show that fecal transplant is effective in treating recurrent C. difficile infection and it should be considered a safe alternative to treat disease associated with C. diff.
Fecal transplant has been documented as highly effective in the treatment of C.-diff-associated diseases in small studies. However, in order to mobilize this type of therapy as a standard of treatment, further validation is needed through documentation of larger controlled studies. Additionally, a more standardized methodology is needed for the procedure in terms of pre-testing of donor stool for infective agents, instillation techniques, post-transplant follow-up, and consistently documented patient outcomes over an extended time period.
Johnette Johnson, BSN, RN, is a graduate of Ramapo College of New Jersey and is currently a master's student in the Science in Nursing Education Program at Ramapo College of New Jersey. She has 14 years experience as an RN, including 10 years in gastroenterology. She is currently working in the endoscopy department at Valley Hospital, in Ridgewood, N.J.
