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stool transplantation
Indications:
1) refractory pseudomembranous colitis*, repeatedly testing positive for C difficile enterotoxin A or enterotoxin B
* patients willing to accept stool transplantation if recommended by their physician [2]
Benefits: 80% cure rate
Procedure:
1) stool donors screened for hepatitis, syphilis, HIV & enteric infections
2) pretreatment of patients with vancomycin & proton pump inhibitor
3) 25 mL of normal stool homogenate instilled via nasogastric tube
Complications:
- risk of infection
a) pneumonia
b) peritonitis
General
clinical procedure
References
- Journal Watch 23(8):63, 2003
Aas J et al,
Recurrent Clostridium difficile colitis: case series involving
18 patients treated with donor stool administered via a
nasogastric tube.
Clin Infect Dis 36:580,2003
PMID: 12594638
- Zipursky JS et al.
Patient attitudes toward the use of fecal microbiota
transplantation in the treatment of recurrent Clostridium
difficile infection.
Clin Infect Dis 2012 Dec 15; 55:1652
PMID: 22990849