AGA临床实践指南关于用于某些胃肠道疾病的便微生物群基础疗法
Anne F Peery1, Colleen R Kelly2, Dina Kao3
1University of North Carolina, Chapel Hill, North Carolina.
Gastroenterology
|February 23, 2024
概括
便微生物群疗法可以预防某些患者的复发性C. difficile感染. 常规的便微生物群移植建议在严重的C. difficile病例中不对抗生素有反应,但在试验之外的IBD或IBS并非如此.
科学领域:
- 胃肠病学 胃肠病学
- 微生物组治疗学 微生物组治疗学
- 临床指南 临床指南
背景情况:
- 基于便微生物群的疗法,包括便微生物群移植 (FMT) 和FDA批准的产品,是新兴的治疗方法.
- 美国胃肠道学会 (AGA) 制定了针对特定胃肠道疾病的FMT使用指南.
研究的目的:
- 为患有复发性或严重的C. difficile感染,炎症性肠病 (IBD) 和刺激性肠综合征 (IBS) 的成年人提供基于证据的便微生物群治疗建议.
主要方法:
- 准则的制定利用了GRADE框架来进行证据综合和证据到决策框架.
- 针对特定患者群体和胃肠道疾病制定了建议.
主要成果:
- 建议以便微生物群为基础的疗法,以预防免疫能力强的成年人服用抗生素后复发的C. difficile.
- 建议在轻度/中度免疫受损的成年人中进行常规的FMT,这些成年人患有复发性C. difficile,以及对抗生素无反应的严重C. difficile.
- 除了临床试验之外,不建议在IBD或IBS治疗中使用FMT. 建议不要在严重免疫功能低下的成年人中使用复发性C. difficile.
结论:
- 基于便微生物群的疗法在预防复发性C. difficile在精选个体中是有效的.
- 传统的FMT作为一种辅助疗法,用于特定的严重的C. difficile感染.
- 目前的证据不支持FMT用于临床试验以外的其他胃肠道疾病.
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