Fecal Bacteriotherapy for Clostridium difficile Infections — Its Time Has Come

Clostridium difficile treatment failures and recurrences occur at rates of 22.3% and 22.1%, respectively. For patients who have refractory/recurrent disease, there are limited treatment options. The use of a fecal suspension from a healthy donor instilled via a nasogastric tube, during colonoscopy, or by enema in a patient with recurrent or refractory C. difficile infection has shown a response rate of 75 to 100% with minimal adverse effects. There are multiple published case series that provide variations in administration procedures. The main barrier is the need for institutions and clinics to develop protocols to ensure this treatment modality is available to patients with this debilitating and potentially fatal disease.