Fecal matters: New evidence shows fecal transplants beat antibiotic

Have investigators dropped a bomb on detractors of fecal transplants? In a real-deal clinical trial, researchers showed that fecal transplants were vastly more effective than a standard antibiotic therapy in treating patients with diarrhea linked with C. difficile.

Fecal transplants have been used for decades to get patients' guts back in order, with plenty of documented successes, but some physicians have rebuffed the approach and pushed its use to the fringes of medicine, Wired reported. Now investigators from Finland and the Netherlands have bolstered the case for the fecal treatments, which repopulate the gut with microbes that enable patients to overcome bouts with diarrhea that resists traditional antibiotic treatments. 

They published the results of their first-of-a-kind randomized study in the respected New England Journal of Medicine, highlighting the fact that they ended the trial early because the fecal transplants were working so much better than treatments involving the antibiotic vancomycin. Transplants cured 15 of 16 patients, or 94% of those who received them, compared with success rates of 31%, or 4 of 13 patients, on vancomycin alone, or 3 of 13 patients (23%) who got vancomycin with lavage therapy.

There are potential implications for the biopharma industry. Biotech researchers have begun to look more closely at how the flora of microbes living in people impact diseases, hoping to that new drugs could emerge from studies of the human microbiome.

Work is also afoot to provide therapies that harness the benefits of fecal transplants without the stigma of using processed poop to treat patients. As Wired reported, investigators from Kingston General Hospital in Ontario have reported curing patients with a fecal substitute that includes the essential fecal bacteria from lab cultures in a saline solution.

- here's the item from NEJM
- see Nature's article
- and the Wired piece