Published in Gastroenterology, Anne Peery, MD, associate professor of medicine in the Division of Gastroenterology and Hepatology at the UNC School of Medicine, authors AGA Clinical Practice Guideline on Fecal Microbiota–Based Therapies for Select Gastrointestinal Diseases.
The American Gastroenterological Association (AGA) developed a guideline published in Gastroenterology to provide recommendations on the use of fecal microbiota–based therapies in adults with recurrent Clostridioides difficile infection; severe to fulminant C difficile infection; inflammatory bowel diseases, including pouchitis; and irritable bowel syndrome. The guideline, first authored by Anne Peery, MD, associate professor of medicine in the Division of Gastroenterology and Hepatology at the UNC School of Medicine, included seven recommendations.
In immunocompetent adults with recurrent C difficile infection, the AGA suggests select use of fecal microbiota–based therapies on completion of standard of care antibiotics to prevent recurrence. In mildly or moderately immunocompromised adults with recurrent C difficile infection, the AGA suggests select use of conventional fecal microbiota transplant. In severely immunocompromised adults, the AGA suggests against the use of any fecal microbiota–based therapies to prevent recurrent C difficile. In adults hospitalized with severe or fulminant C difficile not responding to standard of care antibiotics, the AGA suggests select use of conventional fecal microbiota transplant. The AGA suggests against the use of conventional fecal microbiota transplant as treatment for inflammatory bowel diseases or irritable bowel syndrome, except in the context of clinical trials.
Researchers conclude fecal microbiota–based therapies are effective therapy to prevent recurrent C difficile in select patients.