{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T06:14:11Z","timestamp":1790489651468,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,3,10]],"date-time":"2021-03-10T00:00:00Z","timestamp":1615334400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A defined bacterial mixture could be a safer alternative to faecal microbiota transplantation (FMT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To compare the efficacy of a 12\u2010strain mixture termed rectal bacteriotherapy with either FMT or vancomycin for recurrent <jats:italic>Clostridioides difficile<\/jats:italic> infection (CDI) in an open\u2010label 3\u2010arm randomised controlled trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We screened all individuals positive for <jats:italic>C difficile<\/jats:italic> from May 2017 to March 2019. Persons with laboratory\u2010confirmed recurrent CDI were included. Before FMT and rectal bacteriotherapy, we pre\u2010treated with vancomycin for 7\u201014\u00a0days. Rectal bacteriotherapy was applied by enema on three consecutive days and FMT by enema once with possible repetition for two to three infusions within 14\u00a0days. The vancomycin group was treated for 14\u00a0days with additional five weeks of tapering for multiple recurrences. The primary outcome was clinical cure within 90\u00a0days. A secondary outcome was 180\u2010day all\u2010cause mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Participants in the FMT group (n\u00a0=\u00a034) were cured more often than participants receiving vancomycin (n\u00a0=\u00a031), 76% vs 45% (OR 3.9 (1.4\u201011.4), <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01) or rectal bacteriotherapy (n\u00a0=\u00a031), 76% vs 52% (OR 3.0 (1.1\u20108.8), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.04). Rectal bacteriotherapy and vancomycin performed similarly (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.61). The mortality rate was 6% in the FMT group, 13% in the bacteriotherapy group and 23% in the vancomycin group. FMT tended to reduce mortality compared with vancomycin, OR 0.2 (0.04\u20101.12), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.07.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Rectal bacteriotherapy appears as effective as vancomycin but less effective than 1\u20103 FMTs. FMT by enema with 1\u20103 infusions is superior to vancomycin for treating recurrent <jats:italic>C difficile<\/jats:italic> infections and might reduce mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.16309","type":"journal-article","created":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T14:40:21Z","timestamp":1693579221000},"page":"999-1009","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Randomised clinical trial: a 12\u2010strain bacterial mixture versus faecal microbiota transplantation versus vancomycin for recurrent <i>Clostridioides difficile<\/i> infections"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4995-5169","authenticated-orcid":false,"given":"Anne Abildtrup","family":"Rode","sequence":"first","affiliation":[{"name":"Department of Medicine Zealand University Hospital Koege Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen 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T\u00f8lb\u00f8ll","family":"Svendsen","sequence":"additional","affiliation":[{"name":"Department of Medicine Zealand University Hospital Koege Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iben","family":"Ribberholt","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Hvidovre University Hospital Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten","family":"Helms","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine University of Copenhagen Copenhagen Denmark"},{"name":"Department of Infectious Diseases Hvidovre University Hospital Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f8rgen","family":"Engberg","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology Zealand University Hospital Slagelse Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian","family":"Sch\u00f8nning","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine University of Copenhagen Copenhagen Denmark"},{"name":"Department of Clinical Microbiology Hvidovre University Hospital Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Tvede","sequence":"additional","affiliation":[{"name":"MT MicroSearch by Michael Tvede COBIS Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian \u00d8stergaard","family":"Andersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology Hvidovre University Hospital Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich Stab","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology Zealand University Hospital Slagelse 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