Efficacy of different faecal microbiota transplantation protocols for Clostridium difficile infection: A systematic review and meta-analysis

Gianluca Ianiro, Antonio Gasbarrini, Giovanni Cammarota, Marcello Maida, Johan Burisch, Georgina Hold, Marco Ventimiglia

Risultato della ricerca: Contributo in rivistaArticolo in rivista

71 Citazioni (Scopus)

Abstract

Background: Protocols for treating recurrent Clostridium difficile infection (rCDI) through faecal microbiota transplantation (FMT) are still not standardised. Our aim was to evaluate the efficacy of different FMT protocols for rCDI according to routes, number of infusions and infused material. Methods: MEDLINE, Embase, SCOPUS, Web of Science and the Cochrane Library were searched through 31 May 2017. Studies offering multiple infusions if a single infusion failed to cure rCDI were included. Data were combined through a random effects meta-analysis. Results: Fifteen studies (1150 subjects) were analysed. Multiple infusions increased efficacy rates overall (76% versus 93%) and in each route of delivery (duodenal delivery: 73% with single infusion versus 81% with multiple infusions; capsule: 80% versus 92%; colonoscopy: 78% versus 98% and enema: 56% versus 92%). Duodenal delivery and colonoscopy were associated, respectively, with lower efficacy rates (p = 0.039) and higher efficacy rates (p = 0.006) overall. Faecal amount ≤ 50 g (p = 0.006) and enema (p = 0.019) were associated with lower efficacy rates after a single infusion. The use of fresh or frozen faeces did not influence outcomes. Conclusions: Routes, number of infusions and faecal dosage may influence efficacy rates of FMT for rCDI. These findings could help to optimise FMT protocols in clinical practice.
Lingua originaleEnglish
pagine (da-a)1232-1244
Numero di pagine13
RivistaUnited European Gastroenterology Journal
Volume6
DOI
Stato di pubblicazionePubblicato - 2018

Keywords

  • Clostridium difficile
  • Gastroenterology
  • Oncology
  • faecal microbiota transplantation
  • faecal transplant
  • meta-analysis
  • systematic review

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