{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T04:55:02Z","timestamp":1785214502977,"version":"3.55.0"},"reference-count":17,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,6,19]],"date-time":"2015-06-19T00:00:00Z","timestamp":1434672000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2015,8]]},"abstract":"Summary<\/jats:title>Background<\/jats:title>Severe and severe\/complicated Clostridium difficile<\/jats:italic> infection (CDI<\/jats:styled-content>) can result in ICU<\/jats:styled-content> admission, sepsis, toxic megacolon and death. In this setting, colectomy is the standard of care but it is associated with a 50% mortality.<\/jats:p><\/jats:sec>Aim<\/jats:title>To evaluate safety and efficacy of a sequential faecal microbiota transplantation (FMT<\/jats:styled-content>) and antibiotic protocol in severe and severe\/complicated CDI<\/jats:styled-content> patients who are at high risk for colectomy.<\/jats:p><\/jats:sec>Methods<\/jats:title>All patients with severe and severe\/complicated CDI<\/jats:styled-content> refractory to oral vancomycin\u00a0\u00b1\u00a0rectal vancomycin and intravenous metronidazole therapy were offered FMT<\/jats:styled-content>. Treatment consisted of sequential FMT<\/jats:styled-content>s via colonoscopy with the need for repeat FMT<\/jats:styled-content> and continued vancomycin guided by clinical response and pseudomembranes at colonoscopy.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 29 patients underwent FMT<\/jats:styled-content> between July 2013 and August 2014. The overall treatment response of endoscopic sequential FMT<\/jats:styled-content> was 93% (27\/29), with 100% (10\/10) for severe CDI<\/jats:styled-content> and 89% (17\/19) for severe\/complicated CDI<\/jats:styled-content>. A single FMT<\/jats:styled-content> was performed in 62%, two FMT<\/jats:styled-content>s were performed in 31% and three FMT<\/jats:styled-content>s in 7% of patients. The use of non\u2010CDI<\/jats:styled-content> antibiotics predicted repeat FMT<\/jats:styled-content> (odds ratio\u00a0=\u00a017.5). The 30\u2010day all\u2010cause mortality after FMT<\/jats:styled-content> was 7%, and the cumulative 3\u2010month survival was 76%. Of the two patients who died within 30\u00a0days, one underwent colectomy and succumbed to sepsis; the other died from septic shock related to CDI<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>The success of a treatment protocol for severe and severe\/complicated involving faecal microbiota transplantation and continued vancomycin in selected patients was high, and it warrants further evaluation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.13290","type":"journal-article","created":{"date-parts":[[2015,6,19]],"date-time":"2015-06-19T05:46:29Z","timestamp":1434692789000},"page":"470-476","source":"Crossref","is-referenced-by-count":160,"title":["Faecal microbiota transplantation plus selected use of vancomycin for severe\u2010complicated Clostridium difficile<\/i> infection: description of a protocol with high success rate"],"prefix":"10.1111","volume":"42","author":[{"given":"M.","family":"Fischer","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Indiana University School of Medicine Indianapolis IN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. W.","family":"Sipe","sequence":"additional","affiliation":[{"name":"Community Hospital Anderson IN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. A.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Indiana University School of Medicine Indianapolis IN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. K.","family":"Cook","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Indiana University School of Medicine Indianapolis IN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. W.","family":"Robb","sequence":"additional","affiliation":[{"name":"Department of Surgery Indiana University School of Medicine Indianapolis IN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Vuppalanchi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Indiana University School of Medicine Indianapolis IN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. K.","family":"Rex","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Indiana University School of Medicine Indianapolis IN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,6,19]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.7326\/M14-2693"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.59"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31822ade48"},{"key":"e_1_2_7_5_1","first-page":"854","article-title":"Fecal enema as an adjunct in the treatment of pseudomembranous enterocolitis","volume":"44","author":"Eiseman B","year":"1958","journal-title":"Surgery"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-148-8-200804150-00024"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12017"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e31829004ae"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e3182257d4f"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-014-3296-y"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.4"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2011.08.014"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13144"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e3181dadb10"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir632"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2011.482"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.172.2.191"}],"container-title":["Alimentary Pharmacology & Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fapt.13290","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.13290","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T21:39:11Z","timestamp":1695505151000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.13290"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,6,19]]},"references-count":17,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2015,8]]}},"alternative-id":["10.1111\/apt.13290"],"URL":"https:\/\/doi.org\/10.1111\/apt.13290","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,6,19]]}}}