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Randomised controlled trial
Duodenal infusion of stool is more effective than vancomycin in patients with recurrent Clostridium difficile
  1. Adam M Berg,
  2. Francis A Farraye
  1. Section of Gastroenterology, Boston Medical Center, Boston, Massachusetts, USA
  1. Correspondence to: Dr Francis A Farraye
    Section of Gastroenterology, Boston Medical Center, 85 East Concord St, Suite 7711, Boston, MA 02118, USA; francis.farraye{at}bmc.org

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Commentary on: Van Nood E, Vrieze A, Nieuwdorp M, et al. Duodenal infusion of donor feces for recurrent Clostridium difficile. N Engl J Med 2013;368:407–15.

Context

Clostridium difficile infection (CDI) is increasing in both inpatients and outpatients. CDI accounted for approximately 336 600 inpatient hospitalisations in the USA in 2009.1 Recurrent CDI (RCDI) occurs in 15–30% of patients after the initial infection and in 40–65% with subsequent infections.1 Guidelines recommend that for mild disease, a first recurrence can be treated with the same initial antibiotic regimen; however, severe recurrent disease should be treated with vancomycin.2 Stool transplant or faecal microbiota transplantation (FMT) has been recommended in a recent gastrointestinal (GI) guideline for RCDI.3

Methods

This was the first open-label non-blinded randomised controlled trial in adult patients …

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