Latesha Elopre, MD; Martin Rodriguez, MD
Potential Conflicts of Interest: Dr. Rodriguez: Grants/grants pending:
Elopre L, Rodriguez M. Fecal Microbiota Therapy for Recurrent Clostridium difficile Infection in
HIV-Infected Persons. Ann Intern Med. 2013;158:779-780. doi: 10.7326/0003-4819-158-10-201305210-00021
Download citation file:
Published: Ann Intern Med. 2013;158(10):779-780.
Background: Recurrent Clostridium difficile infection is common and
difficult to manage. It returns in approximately 20% to 30% of cases after a first episode and more
frequently after recurrent episodes (1). Because of the high rate
of recurrence, many treatment alternatives have been proposed, especially metronidazole or vancomycin
(including pulsed or tapered vancomycin); however, these therapies are often unsuccessful (1, 2). Disrupted fecal microbiota from previous antibiotics play a
major role in recurrent C. difficile infection, and fecal microbiota therapy works by
restoring the recipient's natural microbiota (1). The procedure
includes testing the donor for infections that could be transmitted to the recipient, preparing the sample
the same day of the procedure, and administering through nasogastric or colonic routes. Recent publications
describe success rates greater than 90% (1, 3). The procedure
is reportedly safe and has no substantial adverse effects. Most cases have involved immunocompetent persons,
but successful treatment in an allogeneic stem cell transplant recipient has been reported (4). Although not commonly recognized, C. difficile
often occurs in patients with HIV (5), perhaps because of frequent
exposure to antibiotics and an impaired ability to produce antibodies against C. difficile
Learn more about subscription options.
Register Now for a free account.
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only