Concise Commentary: Treatment of Recurrent C. difficile Infection: A New Take on the Fecal–Oral Route

Excerpt

Clostridium difficile infection (CDI) is the most common healthcare-associated infection in the USA [1]. Rates of multiply recurrent and antibiotic-resistant CDI are also increasing at an alarming rate [2]. Given this and the known effectiveness of fecal microbiota transplantation (FMT) in restoring the gut microbiota and preventing recurrence, the diverse modes of administration of FMT have been the focus of recent research [3]. “Lower administration” via enema, flexible sigmoidoscopy or colonoscopy seems to have the best efficacy, although these techniques might limit which providers can perform the procedure. Given this, orally administered capsules offer the broadest access to FMT. One potential issue with capsules is their release of colonic bacteria into the small bowel, with resultant proliferation, potentially causing small intestinal bacterial overgrowth and colonization of the small bowel with colonic flora. …