But this publication marks the first time a randomized controlled trial — the most reliable type of study — has shown that the treatment is effective.
Fecal transplants, first performed in the late 1950s, have come to be regarded by many as the current best chance for cure for people with persistent, recurrent C. difficile.
The idea is relatively simple: Use the feces of a healthy person to restore the normal mix of bacteria to a gut that has been ravaged by C. difficile.
The feces came from donors who had been screened to make sure they didn't have HIV or a number of other infectious diseases. The stools were mixed with saline, stirred and then allowed to sit. Later the fluid was separated from the solids and only the fluid was used in the procedure.
A half-litre of the fluid was dripped into the intestines via the tube. On the day of the procedure most of the patients had diarrhea and some had stomach cramping. But by the next day, most were cured.
"Most people think that patients are reluctant receiving this treatment. But those patients who have relapsed like four or five times, they are just desperate. It's a terrible disease for them with an increased mortality. It just hampers the whole life."
Of 16 patients who received a fecal transplant, 13 were cured after a single treatment. Two of the remaining three were cured after a second transplant from a different donor, for an overall cure rate of 94 per cent.
Only four of 13 patients (31 per cent) who received vancomycin were cured; three of 13 (23 per cent) who had the bowel lavage followed by vancomycin were cured.
Figuring out what is needed to restore the bacterial balance destroyed by C. difficile may allow scientists to devise a targeted transplant — a probiotic treatment, perhaps — that would have the same effect without exposing a patient to someone else's stool.
"We shouldn't believe this is the best we can give," Keller said. "We should give better treatments in the future."
No comments:
Post a Comment