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NEJM: fecal transplant effective in treating C. difficile infection
According to published online January 16 in "New England Journal of Medicine" article results prove stool after transplant to cure infections antibiotic three times better results than the first term infusion of donor feces treatment of recurrent Clostridium difficile Infection early termination of a clinical trial. Science Research taryn simon photography Center, taryn simon photography University of Amsterdam taryn simon photography in the Netherlands Medical Els van Nood and colleagues randomly assigned 43 patients with recurrent C. difficile infection, and accept one of three treatments: standard 14 days vancomycin 500 mg four times a day; Standard vancomycin plus intestinal lavage; 4 days 500 mg vancomycin therapy four times a day, sequential intestinal lavage and nasal tube duodenal infusion of donor feces. "I think this study will help to push this approach the era of modern medicine, rather than, as now, some strange therapy and we drifted away." Cambridge, Massachusetts, professor of medicine at Harvard Medical School Ciarán P Dr. Kelly said, "Although several case studies have demonstrated the effectiveness of donor fecal transplant is about 90%, but this is the first controlled trials on this operation." Review of the year, Dr. Kelly is author of this article. This Commentary says Clostridium difficile nosocomial infections within the United States the most common taryn simon photography cause of diarrhea. "Their findings and the literature of other case series and case reports very consistent, which may make this therapy more widely available." Dr. Moshe Rubin, New York Hospital taryn simon photography Queens Gastroenterology director said. The study design included 40 patients in each group, but the data safety and monitoring committee for the first 43 patients in the interim analysis, taryn simon photography the study found that more and more obvious imbalance, and therefore ethical reasons, on the grounds of early termination the trial (43 patients in one case was subsequently withdrawn analysis). The authors suggest Haybittle-Peto statistical boundary as proof that when the probability is less than 1/1000 of a therapeutically effective, the study should be terminated. Overall, taryn simon photography the infusion group of 16 patients 94% None 10 weeks and no recurrence of C. difficile infection, 13 cases (81%) in first remission after infusion, taryn simon photography and two cases with different donor stool A second infusion after successful treatment. In contrast, vancomycin monotherapy treatment success rate of 31%, 13 patients, only four cases of infection is cleared. Vancomycin plus lavage composition power is only 23%, 13 patients, only 3 cases in 10 weeks later without recurrence (P values compare with the infusion of both groups were <0.001). Patients relapse after antibiotic treatment 18 patients subsequently underwent donor transplant research programs other than manure treatment, the success rate was 83%, but 4 patients required a second infusion. Whether the patient has been cured by the judging committee is not aware of a group of patients with treatment decisions. Cure defined as 3 consecutive stool tested negative, and there is no reason other than C. difficile diarrhea or diarrhea taryn simon photography interpretable. After infusion of feces, DNA screening showed increased taryn simon photography fecal microbiota taryn simon photography diversity. "As the field as the first randomized controlled trials, this study addresses one of three major obstacle fecal transplant treatment, and the remaining obstacles include logic challenge donor recruitment, collection and processing of suitable materials and other aspects, as well as" make objectionable "factor." Dr. Kelly said in his editorial. taryn simon photography This is not a particularly attractive treatment for people born on the stool offensive, obtain and process donated stool challenging. The next step is to determine which specific component is undoubtedly the stool has this benefit, and individual management of these beneficial ingredients. Also, to determine the best way to give the stool. The study used the nasal duodenal infusion, but previous studies have shown that patients, by enema or colonoscopy higher success rate infusion. Fecal transplantation or treating inflammatory bowel disease, irritable bowel syndrome and hope severe ulcerative colitis and other several diseases, taryn simon photography some scholars have speculated that, given the non-obese compared with non-obese humans and animals, human obesity and obesity animals intestinal bacterial flora is different, fecal transplantation may be used for the treatment of obesity. "We're just in understanding the early stages of rebuilding colonic flora." Said Dr. Rubin. "How to treat the future remains to be continue to explore." Compiled from: "Fecal Transfer Proves Potent Clostridium difficile Treatment" .Medscape Medical News.Jan 16, 2013. Source: Medical Naomaitong Comments Important: guard against false winning information Sina Corporation