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Fecal transplants may be the best response to antibiotic-resistant bacteria, according to research

There are several companies with clinical trials of fecal transplants that could bring this treatment to market from 2020


Fecal microbiota transplantation of a human donor into the colon of a patient infected with Clostridiodes difficile & # 39; (C. diff) may be the best treatment for those who do not receive help from targeted antibiotics. According to a Mayo Clinic (US) research published in & # 39; Journal of the American Osteopathy Association.

According to the article, & # 39; C. diff is the most common acquired infection in health care in the United States. It affects nearly half a million patients every year and becomes a recurring infection in almost a third of them. Even if it is not treated, & # 39; C. diff can lead to sepsis and death.

The infectious disease specialist at the Mayo Clinic and the lead author of this article, Dr. Robert Orenstein, stated that "twenty-five years ago, C & D infections were easier to control and often resolved with the suspension of the antibiotic initiator ". However, he continues, "these infections have become increasingly common and pernicious."

The standard treatment approved by the US Food and Drug Administration (FDA) for & # 39; C. diff is a course of oral vancomycin, an antibiotic. However, they explain in the article, even the drugs used to eliminate & # 39; C. diff can perpetuate the infection by killing the beneficial microbes. About this, Dr. Orenstein says "new antibiotics have been developed that aim more specifically" C "diff," but may be prohibitive. "

Similarly, he continues to explain, unlike antibiotics, which are destructive by definition, fecal transplants or microbial replacement therapies, repopulate the intestine with a diverse group of microbes that can block the spore of & C. Differs to germinate and spread diseases through their toxins.

Transplants have several methods of administration, which include enemas, capsules and direct instillation, to replace the diverse flora that maintains health and improves the metabolism.

Currently, according to the article, there are no fecal transplants approved by the FDA and performing fecal transplants is considered a research procedure. About this, Dr. Orestein points out that there are several companies with products in Phase 3 clinical trials that could reach the market after 2020.

For this reason, the physician asks health care professionals to refer patients with & # 39; C. recur? diff? for these tests. Meanwhile, the FDA reserves fecal transplants for patients who have suffered a second (third episode) relapse of & # 39; C. diff & # 39;

Elderly patients are especially vulnerable

According to the researchers, & # 39; C. is common in health settings and public spaces and rarely causes problems in people with intestinal microbiota and a healthy immune system. However, people who are already sick and who take antibiotics, chemotherapy or proton pump inhibitors, which greatly alter the intestinal ecosystem, are at risk. Elderly patients are especially vulnerable.

Orenstein hopes that new treatment options will improve outcomes, but "doctors must take greater responsibility in prevention."

"One of the most effective things doctors can do is to become more responsible with pre-orders for antibiotics," says Dr. Orenstein. "That means just prescribing when they are clearly indicated, not for colds or viral breast infections," he concludes. "You also have to be especially judgmental with elderly patients."

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