indicated that they would certainly
agree to FMT (defined as a score of
9 or 10 on the 10-point Likert scale)
if their physician recommended it.
Physician recommendation for FMT
resulted in the highest overall likelihood of agreeing to FMT, a finding in
agreement with a previous survey of
FMT for CDI. 10 Most subjects indicated likely enrollment in a potential
study comparing FMT with standard
Study strengths included surveying
patients with current CDI, such that
patients had personal experience
with the disease in question. Use of
in-person interviews also resulted in
a robust response rate of 81% and
allowed subjects to clarify any unclear questions with study personnel. Weaknesses included a relatively
small sample size, underrepresentation of women, and lack of detail regarding respondent characteristics.
Additionally, capsule delivery of FMT
was not assessed since this method
of delivery had not been published at
the time of survey administration.
This survey of VA patients with CDI
suggests that aesthetic concerns
are not a critical deterrent for this
population, and interest in FMT for
the treatment of recurrent CDI ex-
ists. Physician recommendation to
undergo FMT seems to be the most
influential factor affecting the likeli-
hood of agreeing to undergo FMT.
These results support the feasibility
of conducting clinical trials of FMT
in the VA system. ●
The authors report no actual or potential conflicts of interest with regard to
The opinions expressed herein are those
of the authors and do not necessarily
reflect those of Federal Practitioner,
Frontline Medical Communications
Inc., the U.S. Government, or any of its
agencies. This article may discuss unlabeled or investigational use of certain
drugs. Please review the complete prescribing information for specific drugs
or drug combinations—including indications, contraindications, warnings,
and adverse effects—before administering pharmacologic therapy to patients.
1. Miller BA, Chen LF, Sexton DJ, Anderson DJ.
Comparison of the burdens of hospital-onset,
healthcare facility-associated Clostridium difficile
Infection and of healthcare-associated infection
due to methicillin-resistant Staphylococcus aureus
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2. Centers for Disease Control and Prevention.
Severe Clostridium difficile-associated disease
in populations previously at low risk—four
states, 2005. MMWR Morb Mortal Wkly Rep.
3. Johnson S, Louie TJ, Gerding DN, et al; Polymer
Alternative for CDI Treatment (PACT) investigators. Vancomycin, metronidazole, or tolevamer
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5. Centers for Disease Control and Prevention.
Antibiotic resistance threats in the United
States, 2013. http://www.cdc.gov/drugresistance
/threat-report-2013. Updated July 17, 2014.
Accessed November 16, 2016.
6. Cohen SH, Gerding DN, Johnson S, et al; Society
for Healthcare Epidemiology of America; Infectious Diseases Society of America. Clinical practice guidelines for Clostridium difficile infection in
adults: 2010 update by the society for healthcare
epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA). Infect
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80-004 Clinical Study Group. Fidaxomicin versus vancomycin for infection with Clostridium
difficile in Europe, Canada, and the USA: a double-blind, non-inferiority, randomised controlled
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8. Johnson S. Recurrent Clostridium difficile infection: a review of risk factors, treatments, and
outcomes. J Infect. 2009;58( 6):403-410.
9. Drekonja DM, Reich J, Gezahegn S, et al. Fecal
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the use of fecal microbiota transplantation in the
treatment of recurrent Clostridium difficile infection. Clin Infect Dis. 2012;55( 12):1652-1658.
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