Fecal Microbiota Transplantation for Recurrent Clostridioides Difficile Infection: A Clinical Review
Date of Award
2027
Document Type
Capstone
Degree Name
Master of Science (MS)
Department
Physician Assistant Studies
Committee Chair
LaDonna Clark
Abstract
Introduction: Clostridioides difficile infection (CDI) is a common healthcare-associated infection that frequently recurs after standard antibiotic treatment due to persistent disruption of the intestinal microbiome. Fecal microbiota transplantation (FMT) has emerged as a microbiota-based therapy that may reduce recurrence by restoring normal intestinal bacterial diversity.
Methods: A literature review was conducted using PubMed to identify English randomized controlled trials, systematic reviews, and meta-analyses published between 2021 and 2026. Four studies that directly compared FMT with standard antibiotic treatment were included. A fifth randomized controlled trial was added with a second targeted search because the initial search not contain enough randomized controlled trials and did not account for British spelling.
Results: Evidence across the studies demonstrated that FMT improved clinical resolution and reduced recurrence compared with standard antibiotic therapy alone. A network meta-analysis of more than 25,000 participants ranked FMT as the most effective treatment for recurrent CDI. A Cochrane systematic review found that FMT was more effective than placebo, autologous FMT, and vancomycin, with a number needed to treat of three. Additionally, systematic reviews and a randomized controlled trial also reported higher cure rates and lower recurrence with FMT.
Conclusion: Current evidence supports FMT as a more effective treatment than standard antibiotic therapy alone for reducing recurrence of CDI in adults. Although there are limitations due to differences in study design, administration methods, and restricted patient populations, FMT shows promise as a therapy that can improve long-term outcomes. Additional large, randomized trials with longer follow-up are needed to further define its role in the treatment of CDI.
Recommended Citation
Drinkwalter BH. Fecal Microbiota Transplantation for Recurrent Clostridioides Difficile Infection: A Clinical Review. The PA Department Journal of Medical Science. 2026. https://digitalcommons.gardner-webb.edu/pa-department-journal-of-medical-science/96
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