Efficacy of Fecal Microbiota Transplantation (FMT) Versus Standard Antibiotic Therapy in Recurrent Clostridioides...

Repeated Clostridioides difficile infection (rCDI) is a hard clinical problem because normal antibiotic treatment usually doesn't stop relapses. Fecal microbiota transplantation (FMT) has come up as another way to try to fix the gut's microbial balance. This review and study looked at how well FMT works and how safe it is compared to normal antibiotic treatment for rCDI. We searched PubMed, Embase, and the Cochrane Library up to December 2023 to find trials and studies. We used a model to calculate risk ratios, and we also looked at subgroups based on how FMT was given and the patient's age. After checking fifteen studies with 1,452 patients, we found that FMT worked better than antibiotics [relative risk (RR) = 1.85, 95% confidence interval (CI): 1.62-2.11, p < 0.001], with recurrence rates of 16% versus 42%. Subgroup checks showed that FMT worked well no matter how it was given, whether by colonoscopy, tube, or capsules. Side effects were usually small and about the same for both FMT and antibiotics. In conclusion, FMT is safer and does a better job than normal antibiotics for rCDI and should be thought of as the main treatment after the first time the infection comes back.