Pharmacy and Wellness Review


Fecal microbiota transplant (FMT) therapy is an increasingly prevalent treatment option for Clostridium difficile infection (CDI). Clostridium difficile infection is an aggressive and potentially fatal disease state, and antibiotic therapy often fails to resolve the disease state effectively. Clostridium difficile infection occurs most commonly subsequent to the use of antimicrobial agents that disrupt the natural bacterial flora of the gastrointestinal (GI) tract. Since disease state pathophysiology operates in this way, researchers have experimented with ways to restore GI flora to a natural state in which nonpathogenic bacteria can proliferate. Probiotic agents do not impose an acute enough response to recreate typical GI tract flora, which has led to experimentation with direct supplementation of GI bacteria, thus underlying the purpose of FMT therapy. Presently, FMT has demonstrated unparalleled efficacy in resolving CDI and is poised to become first-line therapy as the body of evidence supporting its use continues to grow. This review examines the mechanism of action for FMT therapy and evaluates the results of clinical trials that have tested FMT therapy. Finally, the potential role for pharmacists in the management of patients with CDI will be discussed. Research has supported both the expanded use of FMT therapy in CDI and the establishment of standard practices for administering FMT therapy in hospitals treating larger numbers of CDI patients. Furthermore, additional clinical trials that could supplement existing support for FMT therapy are currently recruiting patients.



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