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Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
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Consensus report: faecal microbiota transfer - clinical applications and procedures.

J König1, A Siebenhaar2, C Högenauer3

  • 1Örebro, Sweden.

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Faecal microbiota transplantation (FMT) is recommended for recurrent Clostridium difficile infection. For other conditions like IBD and IBS, FMT should only be used in research settings due to insufficient evidence.

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Area of Science:

  • Gastroenterology
  • Microbiome Research
  • Clinical Therapeutics

Background:

  • Faecal microbiota transplantation (FMT) involves transferring gut microbiota from a healthy donor to a patient.
  • Limited controlled studies exist for FMT indications beyond Clostridium difficile infection.
  • Clinicians face challenges in determining appropriate uses for FMT.

Purpose of the Study:

  • To establish an expert consensus on current clinical indications for FMT.
  • To define best practices for FMT applications and methodology.
  • To guide clinical decision-making regarding FMT use.

Main Methods:

  • A modified Delphi process involving European experts was employed.
  • Literature review and iterative manuscript circulation facilitated consensus.
  • GRADE system was used to rate evidence and agreement levels.

Main Results:

  • FMT is recommended for recurrent C. difficile infection after failed standard treatments.
  • FMT is a consideration for severe C. difficile infection, potentially avoiding colectomy.
  • FMT for IBD, IBS, and metabolic syndrome is restricted to research settings.

Conclusions:

  • FMT shows promise for various microbiota-disturbed diseases.
  • Further evidence is required to support FMT recommendations beyond C. difficile infection.
  • Current consensus restricts FMT use to specific indications and research.