Donor feces cure recurrent diarrhea, study finds

An infusion of feces through the nose beat the standard antibiotic as a treatment for a recurrent diarrhea-causing infection that kills about 14,000 Americans a year, a study showed.

In a trial among 43 people with recurrent diarrhea caused by a persistent bug called Clostridium difficile, 81 percent of those who received an infusion of feces from a healthy donor after treatment with vancomycin were cured, compared with only 31 percent of those treated with the drug alone, University of Amsterdam researchers wrote in the New England Journal of Medicine. The study was stopped early because the treatment was clearly working.

The results validate an approach called fecal microbiota transplantation, or FMT, pioneered in 1958 by doctors in Denver, and provides an alternative for the one in four patients whose infection isn't cleared by initial antibiotic treatment. C. difficile is the most common cause of hospital-acquired infectious diarrhea in the United States and costs about $1 billion a year to treat, the Centers for Disease Control and Prevention says.

"Only patients with the most recalcitrant cases of C. difficile infection are likely to undergo FMT, usually out of desperation after multiple treatment approaches have failed," Ciaran Kelly, a Harvard Medical School professor, wrote in an editorial accompanying the study. The use of feces may be eliminated by the use of cultured bacteria that make the recipient resistant to C. difficile, he said.

The procedure probably works by restoring normal gut bacteria, the researchers, led by Els van Nood, wrote in the study, which was funded by two Netherlands research organizations.