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 "slug": "fecal-microbiota-transplantation",
 "title": "Fecal microbiota transplantation",
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 "excerpt": "Fecal microbiota transplantation (FMT) is the transfer of processed stool from a screened healthy donor into a patient's gut, curing 80–90% of recurrent C. difficile infections.",
 "snippet": "Fecal microbiota transplantation (FMT) is the transfer of processed stool from a screened healthy donor into a patient's gut, curing 80–90% of recurrent C. difficile infections.",
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 "markdown": "# Fecal microbiota transplantation\n\nFecal microbiota transplantation (FMT) is the transfer of processed stool from a screened healthy donor into a patient's gastrointestinal tract to restore microbial communities disrupted by antibiotics and disease. Its dominant indication is recurrent *Clostridioides difficile* infection (CDI), where the goal is to re-establish colonization resistance, the ecological barrier that resident gut bacteria mount against pathogens. In the United States, nearly half a million people each year experience *C. difficile*, and one in six of them has a recurrence within two to eight weeks.<sup>[1](https://gastro.org/press-releases/aga-recommends-fecal-transplant-for-recurrent-cdiff-patients/)</sup> Practice guidelines now place FMT-based therapies among the most effective options for recurrent CDI, with reported efficacy of 80–90%.<sup>[2](https://journals.asm.org/doi/10.1128/cmr.00060-22)</sup>\n\n| Key fact | Detail |\n|---|---|\n| What a dose delivers | Rebyota: 50 g donor stool in 150 mL saline/PEG 3350, 15 billion to 7.5 trillion CFU per dose<sup>[3](https://journals.lww.com/ajg/fulltext/2024/01001/prescription_microbiome_therapeutic_for_recurrent.5.aspx)</sup>; Vowst: four oral capsules daily for 3 days, each with \\( 1 \\times 10^{6} \\) to \\( 3 \\times 10^{7} \\) Firmicutes spore CFU<sup>[4](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=99e5a37a-930c-4641-bcdd-7013ec1c15fe)</sup> |\n| Intended effect | Restoration of colonization resistance through competitive niche exclusion, bacteriocins, secondary bile acid metabolism, and immunomodulation<sup>[5](https://gut.bmj.com/content/69/1/83)</sup> |\n| Efficacy in recurrent CDI | 80–90%; a Cochrane meta-analysis of 6 RCTs (320 participants) found RR 1.92 (95% CI 1.36–2.71) versus control, NNT = 3<sup>[2](https://journals.asm.org/doi/10.1128/cmr.00060-22)</sup> |\n| Landmark trial | van Nood 2013: 94% cure with donor feces versus 31% with vancomycin alone<sup>[6](https://www.nejm.org/doi/full/10.1056/NEJMoa1205037)</sup> |\n| Safety | Adverse events in 19% of procedures (diarrhea 10%, abdominal pain 7%); serious adverse events in 1.4% of patients<sup>[7](https://onlinelibrary.wiley.com/doi/10.1111/apt.16148)</sup> |\n| Donor yield | Fewer than 3% of prospective donors qualify at the largest US stool bank<sup>[8](https://mdpi-res.com/d_attachment/diseases/diseases-08-00009/article_deploy/diseases-08-00009.pdf?version=1586951946)</sup> |\n| Comparative ranking | Network meta-analysis of 73 RCTs (27,959 patients): FMT most effective for cure, P-score 0.9952 overall and 0.9836 in recurrent cases<sup>[9](https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762%2824%2900320-X/fulltext)</sup> |\n\n## How it works\n\nColonization resistance is the central mechanism. Proposed pathways include competitive niche exclusion against *C. difficile*, bacteriocin production, quorum sensing effects, restoration of secondary bile acid metabolism, and immunomodulation through IL-10 production and increases in Foxp3+ regulatory T cells.<sup>[5](https://gut.bmj.com/content/69/1/83)</sup> After infusion, fecal bacterial diversity rises to resemble the donor's, with increases in [Bacteroidetes](https://www.edgepedia.org/bacteroidetes) and clostridial clusters IV and XIVa and a decrease in Proteobacteria.<sup>[6](https://www.nejm.org/doi/full/10.1056/NEJMoa1205037)</sup> The bile acid signal is consistent: FMT restores Firmicutes and secondary bile acid metabolism, and in the Vowst phase 3 trial secondary bile acids increased after treatment, with engraftment apparent by one week.<sup>[5](https://gut.bmj.com/content/69/1/83)</sup><sup> • </sup><sup>[10](https://pmc.ncbi.nlm.nih.gov/articles/PMC12377394/)</sup> Whether live organisms are strictly required is not settled; a trial of sterile fecal filtrate transfer for CDI tested a cell-free preparation.<sup>[11](https://doi.org/10.1053/j.gastro.2016.11.010)</sup>\n\n## How it is done\n\n**Donor screening.** The 2013 trial protocol screened donors under 60 by questionnaire plus blood and stool tests for HIV, hepatitis, syphilis, parasites, *C. difficile*, and enteropathogenic bacteria, re-screening the donor pool every 4 months.<sup>[6](https://www.nejm.org/doi/full/10.1056/NEJMoa1205037)</sup> After the 2019 safety incidents, FDA-required stool testing must at minimum cover ESBL-producing Enterobacteriaceae, vancomycin-resistant enterococci, carbapenem-resistant [Enterobacteriaceae](https://www.edgepedia.org/enterobacteriaceae), and MRSA.<sup>[12](https://www.fda.gov/safety/medical-product-safety-information/fecal-microbiota-transplantation-safety-communication-risk-serious-adverse-reactions-due)</sup> Current licensed-product screening adds [SARS-CoV-2](https://www.edgepedia.org/sars-cov-2), enteropathogenic and [Shiga toxin](https://www.edgepedia.org/shiga-toxin)-producing *E. coli*, and norovirus.<sup>[13](https://pubmed.ncbi.nlm.nih.gov/37333464/)</sup> In March 2020 the FDA warned that SARS-CoV-2 may be transmitted in fecal samples and recommended using stool donated before December 1, 2019 when possible.<sup>[8](https://mdpi-res.com/d_attachment/diseases/diseases-08-00009/article_deploy/diseases-08-00009.pdf?version=1586951946)</sup> Screening is selective: fewer than 3% of prospective donors qualify at the largest US stool bank.<sup>[8](https://mdpi-res.com/d_attachment/diseases/diseases-08-00009/article_deploy/diseases-08-00009.pdf?version=1586951946)</sup>\n\n**Processing.** Sterile 0.9% saline is the recommended diluent, with glycerol added as cryoprotectant for frozen material; bowel lavage with polyethylene glycol is recommended before lower GI delivery.<sup>[14](https://gut.bmj.com/content/67/11/1920)</sup> For oral capsules, roughly 12 cc of sediment estimated to contain \\( 10^{13} \\) microbes yields 40 capsules from a single 80–100 g donation.<sup>[15](https://jamanetwork.com/journals/jama/fullarticle/2664458)</sup>\n\n**Administration.** Fecal microbiota-based therapies are given after standard-of-care antibiotics, ideally stopped 1–3 days before conventional FMT; Rebyota is given 24–72 hours after antibiotic completion.<sup>[16](https://assets.ctfassets.net/07cwnclyy106/3iCJTUb80mNIoyO4npDtXY/3f3222a0a007fddb8008f435406b4836/EGT-3592.v1_Download.pdf)</sup><sup> • </sup><sup>[3](https://journals.lww.com/ajg/fulltext/2024/01001/prescription_microbiome_therapeutic_for_recurrent.5.aspx)</sup> For hospitalized patients with severe or fulminant CDI not responding within 2–5 days, colonoscopy or flexible sigmoidoscopy is preferred, with repeat dosing generally every 3–5 days.<sup>[16](https://assets.ctfassets.net/07cwnclyy106/3iCJTUb80mNIoyO4npDtXY/3f3222a0a007fddb8008f435406b4836/EGT-3592.v1_Download.pdf)</sup>\n\n## Origin\n\nPrecursors are old. The Chinese scholar [Ge Hong](https://www.edgepedia.org/ge-hong) used oral fecal suspension for severe diarrhea over 1,700 years ago; Such suspensions were called \"yellow soup\"; and World War II soldiers in North Africa treated dysentery with camel dung after observing locals do so.<sup>[17](https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2018.01242/full)</sup> The first description of a fecal enema in modern medical literature dates from 1958, when Eiseman and colleagues treated four patients with pseudomembranous colitis.<sup>[17](https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2018.01242/full)</sup> *C. difficile* was identified in the gut microbiota of healthy infants and reclassified as *[Clostridioides](https://www.edgepedia.org/clostridioides)* in 2016 by Lawson and colleagues in [Anaerobe](https://www.edgepedia.org/anaerobe).<sup>[17](https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2018.01242/full)</sup><sup> • </sup><sup>[18](https://doi.org/10.1016/j.anaerobe.2016.06.008)</sup> In 2013, FMT was recognized as a standard treatment for recurrent *C. difficile* because it consistently showed high efficacy,<sup>[19](https://link.springer.com/article/10.1007/s12275-024-00184-3)</sup> on the strength of the randomized trial of duodenal donor-feces infusion by van Nood and colleagues reported that year in the New England Journal of Medicine.<sup>[6](https://www.nejm.org/doi/full/10.1056/NEJMoa1205037)</sup>\n\n## Variants\n\n**Preparations and routes.** A standardized frozen preparation for recurrent CDI was reported by Hamilton and colleagues in 2012 in The American Journal of Gastroenterology.<sup>[20](https://doi.org/10.1038/ajg.2011.482)</sup> A frozen-versus-fresh noninferiority RCT followed in 2016 (Lee and colleagues, JAMA).<sup>[21](https://doi.org/10.1001/jama.2015.18098)</sup> Oral capsulized frozen FMT was reported in 2014 by Youngster and colleagues in JAMA,<sup>[22](https://doi.org/10.1001/jama.2014.13875)</sup> and a 2017 RCT by Kao and colleagues found capsules noninferior to colonoscopy delivery.<sup>[15](https://jamanetwork.com/journals/jama/fullarticle/2664458)</sup> A defined-consortium \"stool substitute\" (RePOOPulate) was reported in 2013 by Petrof and colleagues in [Microbiome](https://www.edgepedia.org/microbiome) as an alternative to whole stool.<sup>[23](https://doi.org/10.1186/2049-2618-1-3)</sup>\n\n**Stool banks.** OpenBiome data from 1,999 treated patients across 28 donors showed an overall cure rate of 84.4% with no donor effect.<sup>[2](https://journals.asm.org/doi/10.1128/cmr.00060-22)</sup> After a November 2022 FDA guidance required stool banks to hold an IND, OpenBiome halted shipped frozen FMT on December 31, 2024, having shipped 72,507 treatments to over 1,300 facilities.<sup>[24](https://link.springer.com/article/10.1007/s11894-025-01030-1)</sup>\n\n**Licensed and pipeline products.** Rebyota (fecal microbiota, live-jslm; formerly RBX2660) was approved November 30, 2022 as a 150 mL rectal suspension.<sup>[10](https://pmc.ncbi.nlm.nih.gov/articles/PMC12377394/)</sup> Vowst (fecal microbiota spores, live-brpk; formerly SER-109) was approved April 26, 2023 as the first oral live biotherapeutic product, made by ethanol-treating fecal matter to kill non-spore organisms followed by filtration.<sup>[25](https://pmc.ncbi.nlm.nih.gov/articles/PMC11117328/)</sup><sup> • </sup><sup>[4](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=99e5a37a-930c-4641-bcdd-7013ec1c15fe)</sup> Investigational products include RBX7455, a lyophilized room-temperature capsule reporting 90% primary treatment efficacy, CP101 at 88% clinical success,<sup>[5](https://gut.bmj.com/content/69/1/83)</sup> VE303 (a defined bacterial consortium), and NTCD-M3, a single non-toxigenic *C. difficile* strain.<sup>[10](https://pmc.ncbi.nlm.nih.gov/articles/PMC12377394/)</sup>\n\n## Applications\n\n**Recurrent CDI.** In the 2013 trial, 13 of 16 infusion patients (81%) resolved after the first infusion and 15 of 16 (94%) overall, versus 31% on vancomycin alone and 23% on vancomycin with bowel lavage.<sup>[6](https://www.nejm.org/doi/full/10.1056/NEJMoa1205037)</sup> A meta-analysis of 37 studies (1,973 patients) pooled clinical resolution at 92%, with lower GI delivery at 95% versus 88% for upper GI (P=.02) and no fresh-versus-frozen difference.<sup>[26](https://onlinelibrary.wiley.com/doi/10.1111/apt.14201)</sup> NICE's review of 5 RCTs found resolution of 57–94% with FMT versus 19–46% with antibiotics, and recurrence of 6–10% versus 62–69% for vancomycin.<sup>[27](https://www.nice.org.uk/guidance/htg638/resources/faecal-microbiota-transplant-for-recurrent-clostridioides-difficile-infection-pdf-1809598532788933)</sup> Real-world results are lower: in a Danish cohort of 1,170 patients, 60% were cured eight weeks after the first FMT and 81% after repeated treatments.<sup>[28](https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370%2825%2900234-2/fulltext?rss=yes)</sup> For the licensed products, Rebyota achieved 70.6% versus 57.5% placebo cure in phase 3,<sup>[3](https://journals.lww.com/ajg/fulltext/2024/01001/prescription_microbiome_therapeutic_for_recurrent.5.aspx)</sup> and Vowst reduced 24-week recurrence to 21.3% versus 47.3%.<sup>[4](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=99e5a37a-930c-4641-bcdd-7013ec1c15fe)</sup>\n\n**Beyond CDI.** Pooled data from four studies (277 participants) showed FMT induced remission in 37% of ulcerative colitis patients at week eight versus 18% of controls.<sup>[29](https://www.mdpi.com/2077-0383/14/15/5260)</sup> The 2024 AGA guideline nevertheless recommends against conventional FMT for inflammatory bowel disease or irritable bowel syndrome outside clinical trials.<sup>[30](https://pubmed.ncbi.nlm.nih.gov/38395525/)</sup> Investigational indications include decolonizing multidrug-resistant organisms, liver disease, and metabolic syndrome.<sup>[10](https://pmc.ncbi.nlm.nih.gov/articles/PMC12377394/)</sup>\n\n## Limitations and alternatives\n\n**Safety.** Across 129 studies (4,241 patients, 5,688 courses), FMT-related adverse events occurred in 19% of procedures, most often diarrhea (10%) and abdominal pain (7%); serious adverse events occurred in 1.4% of patients, and four of five FMT-related deaths were via the upper GI route, with all reported SAEs in patients with mucosal barrier injury.<sup>[7](https://onlinelibrary.wiley.com/doi/10.1111/apt.16148)</sup> [Pathogen transmission](https://www.edgepedia.org/pathogen-transmission) has occurred: in 2019, two immunocompromised recipients developed invasive ESBL-producing *E. coli* infections from stool of a single untested donor, and one died,<sup>[12](https://www.fda.gov/safety/medical-product-safety-information/fecal-microbiota-transplantation-safety-communication-risk-serious-adverse-reactions-due)</sup><sup> • </sup><sup>[31](https://doi.org/10.1056/nejmoa1910437)</sup> prompting mandatory MDRO screening by July 15, 2019. FDA treats FMT as a biological product and a drug, extending enforcement discretion only to provider-prepared FMT for CDI not responsive to standard therapies, not to stool-bank distribution.<sup>[32](https://www.fda.gov/media/86440/download?attachment=)</sup> Long-term engraftment risks may include susceptibility to obesity and immune-mediated disorders.<sup>[33](https://e-ce.org/journal/view.php?doi=10.5946%2Fce.2024.270)</sup>\n\n**Alternatives.** The 2021 IDSA/SHEA guidelines prefer fidaxomicin 200 mg twice daily for recurrent CDI, with oral vancomycin as an alternative and FMT listed for multiple recurrences.<sup>[25](https://pmc.ncbi.nlm.nih.gov/articles/PMC11117328/)</sup> The AGA lists vancomycin taper, pulsed fidaxomicin, or bezlotoxumab as reasonable alternatives for patients not choosing fecal microbiota-based therapies.<sup>[16](https://assets.ctfassets.net/07cwnclyy106/3iCJTUb80mNIoyO4npDtXY/3f3222a0a007fddb8008f435406b4836/EGT-3592.v1_Download.pdf)</sup> Head-to-head, an RCT by Hvas and colleagues published in [Gastroenterology](https://www.edgepedia.org/gastroenterology) in 2019 found FMT superior to fidaxomicin for recurrent CDI,<sup>[34](https://doi.org/10.1053/j.gastro.2018.12.019)</sup> while fidaxomicin showed lower recurrence than vancomycin in severe CDI (13.0% vs 26.6%) and bezlotoxumab reduced severe CDI recurrence versus standard of care (10.9% vs 20%).<sup>[14](https://gut.bmj.com/content/67/11/1920)</sup> Two comparisons remain unresolved in the literature: whether oral and colonoscopic delivery are equally effective (a 2024 network meta-analysis found them equal,<sup>[9](https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762%2824%2900320-X/fulltext)</sup> while a meta-analysis found lower GI delivery superior, 95% vs 88%<sup>[26](https://onlinelibrary.wiley.com/doi/10.1111/apt.14201)</sup>), and why real-world cure rates (60% after first FMT<sup>[28](https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370%2825%2900234-2/fulltext?rss=yes)</sup>) fall below RCT figures (84–94%<sup>[6](https://www.nejm.org/doi/full/10.1056/NEJMoa1205037)</sup><sup> • </sup><sup>[26](https://onlinelibrary.wiley.com/doi/10.1111/apt.14201)</sup>). The AGA guideline published in 2024 recommends fecal microbiota-based therapy for most patients with recurrent CDI, with an exception for the severely immunocompromised.<sup>[30](https://pubmed.ncbi.nlm.nih.gov/38395525/)</sup><sup> • </sup><sup>[1](https://gastro.org/press-releases/aga-recommends-fecal-transplant-for-recurrent-cdiff-patients/)</sup>\n\n## References\n\n1. [AGA now recommends fecal microbiota transplant for the majority of recurrent C. diff patients (press release, Feb 21, 2024)](https://gastro.org/press-releases/aga-recommends-fecal-transplant-for-recurrent-cdiff-patients/)\n2. [Fecal microbiota transplantation: current challenges and future landscapes (Clinical Microbiology Reviews, 2024)](https://journals.asm.org/doi/10.1128/cmr.00060-22)\n3. [Prescription Microbiome Therapeutic for Recurrent C. difficile Infection: Rebyota (American Journal of Gastroenterology, 2024)](https://journals.lww.com/ajg/fulltext/2024/01001/prescription_microbiome_therapeutic_for_recurrent.5.aspx)\n4. [VOWST (fecal microbiota spores, live-brpk) capsule, official drug label (DailyMed)](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=99e5a37a-930c-4641-bcdd-7013ec1c15fe)\n5. [Scientific frontiers in faecal microbiota transplantation: joint APAGE/APSDE document (Gut, 2020)](https://gut.bmj.com/content/69/1/83)\n6. [Duodenal Infusion of Donor Feces for Recurrent Clostridium difficile (van Nood et al., NEJM 2013)](https://www.nejm.org/doi/full/10.1056/NEJMoa1205037)\n7. [Systematic review: the global incidence of FMT-related adverse events from 2000 to 2020 (Alimentary Pharmacology & Therapeutics)](https://onlinelibrary.wiley.com/doi/10.1111/apt.16148)\n8. [From Donor to Patient: Collection, Preparation and Cryopreservation of Fecal Samples for FMT (Diseases, 2020)](https://mdpi-res.com/d_attachment/diseases/diseases-08-00009/article_deploy/diseases-08-00009.pdf?version=1586951946)\n9. [fulltext (thelancet.com)](https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762%2824%2900320-X/fulltext)\n10. [What's New and What's Next in Fecal Microbiota Transplantation? (post-2023 review)](https://pmc.ncbi.nlm.nih.gov/articles/PMC12377394/)\n11. [Stephan J. Ott and colleagues (2016). Efficacy of Sterile Fecal Filtrate Transfer for Treating Patients With Clostridium difficile Infection. Gastroenterology.](https://doi.org/10.1053/j.gastro.2016.11.010)\n12. [FDA Safety Communication: Risk of Serious Adverse Reactions Due to Transmission of Multi-Drug Resistant Organisms (June 2019)](https://www.fda.gov/safety/medical-product-safety-information/fecal-microbiota-transplantation-safety-communication-risk-serious-adverse-reactions-due)\n13. [Safety of fecal microbiota, live-jslm (REBYOTA) in individuals with recurrent C. difficile infection: data from five prospective clinical trials](https://pubmed.ncbi.nlm.nih.gov/37333464/)\n14. [BSG/HIS joint guidelines on FMT for recurrent or refractory C. difficile infection (Gut, 2018)](https://gut.bmj.com/content/67/11/1920)\n15. [Effect of Oral Capsule– vs Colonoscopy-Delivered Fecal Microbiota Transplantation on Recurrent C. difficile Infection (Kao et al., JAMA 2017)](https://jamanetwork.com/journals/jama/fullarticle/2664458)\n16. [ECRI Guidelines Trust, AGA clinical practice guideline on fecal microbiota-based therapies (full text)](https://assets.ctfassets.net/07cwnclyy106/3iCJTUb80mNIoyO4npDtXY/3f3222a0a007fddb8008f435406b4836/EGT-3592.v1_Download.pdf)\n17. [Mechanistic Insights in the Success of Fecal Microbiota Transplants for the Treatment of C. difficile Infections (Frontiers in Microbiology, 2018)](https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2018.01242/full)\n18. [Paul A. Lawson and colleagues (2016). Reclassification of Clostridium difficile as Clostridioides difficile (Hall and O’Toole 1935) Prévot 1938. Anaerobe.](https://doi.org/10.1016/j.anaerobe.2016.06.008)\n19. [Fecal Microbiota Transplantation: Indications, Methods, and Challenges (Journal of Microbiology, 2024)](https://link.springer.com/article/10.1007/s12275-024-00184-3)\n20. [Matthew J Hamilton and colleagues (2012). Standardized Frozen Preparation for Transplantation of Fecal Microbiota for Recurrent Clostridium difficile Infection. The American Journal of Gastroenterology.](https://doi.org/10.1038/ajg.2011.482)\n21. [Christine H. Lee and colleagues (2016). Frozen vs Fresh Fecal Microbiota Transplantation and Clinical Resolution of Diarrhea in Patients With Recurrent Clostridium difficile Infection. JAMA.](https://doi.org/10.1001/jama.2015.18098)\n22. [Ilan Youngster and colleagues (2014). Oral, Capsulized, Frozen Fecal Microbiota Transplantation for Relapsing Clostridium difficile Infection. JAMA.](https://doi.org/10.1001/jama.2014.13875)\n23. [Elaine O Petrof and colleagues (2013). Stool substitute transplant therapy for the eradication of Clostridium difficile infection: ‘RePOOPulating’ the gut. Microbiome.](https://doi.org/10.1186/2049-2618-1-3)\n24. [Fecal Microbiota Transplantation in 2025: Two Steps Forward, One Step Back (Current Gastroenterology Reports)](https://link.springer.com/article/10.1007/s11894-025-01030-1)\n25. [A Comparison of Currently Available and Investigational Fecal Microbiota Transplant Products for Recurrent C. difficile Infection (2024)](https://pmc.ncbi.nlm.nih.gov/articles/PMC11117328/)\n26. [Systematic review with meta-analysis: efficacy of FMT for recurrent and refractory C. difficile infection (Alimentary Pharmacology & Therapeutics)](https://onlinelibrary.wiley.com/doi/10.1111/apt.14201)\n27. [NICE guidance: Faecal microbiota transplant for recurrent Clostridioides difficile infection](https://www.nice.org.uk/guidance/htg638/resources/faecal-microbiota-transplant-for-recurrent-clostridioides-difficile-infection-pdf-1809598532788933)\n28. [fulltext (thelancet.com)](https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370%2825%2900234-2/fulltext?rss=yes)\n29. [Intestinal Microbiota and Fecal Transplantation in Patients with Inflammatory Bowel Disease and Clostridioides difficile: An Updated Literature Review (Journal of Clinical Medicine, 2025)](https://www.mdpi.com/2077-0383/14/15/5260)\n30. [AGA Clinical Practice Guideline on Fecal Microbiota-Based Therapies for Select Gastrointestinal Diseases (2024)](https://pubmed.ncbi.nlm.nih.gov/38395525/)\n31. [Zachariah DeFilipp and colleagues (2019). Drug-Resistant E. coli Bacteremia Transmitted by Fecal Microbiota Transplant. New England Journal of Medicine.](https://doi.org/10.1056/nejmoa1910437)\n32. [FDA Enforcement Policy Regarding IND Requirements for Use of Fecal Microbiota for Transplantation to Treat CDI Not Responsive to Standard Therapies (Guidance for Industry)](https://www.fda.gov/media/86440/download?attachment=)\n33. [Fecal microbiota transplantation: present and future (Clinical Endoscopy)](https://e-ce.org/journal/view.php?doi=10.5946%2Fce.2024.270)\n34. [Christian Lodberg Hvas and colleagues (2019). Fecal Microbiota Transplantation Is Superior to Fidaxomicin for Treatment of Recurrent Clostridium difficile Infection. Gastroenterology.](https://doi.org/10.1053/j.gastro.2018.12.019)\n\n---\n*Topic: Encyclopedia › Life and health › Human health and medicine › Clinical assessment and procedures › Organ and tissue transplantation › Titles A to La*\n\n*Initially written Sep 29, 2026 · Reviewed: Sep 30, 2026 · Edited: Sep 30, 2026 · Last review: Sep 30, 2026*\n\n*Copyright 2026 EdgeChat AI, a subsidiary of Biostate AI.*\n\nLicense: Edgepedia Community License 1.0, https://www.edgepedia.org/edgepedia/license\n",
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 "credit_md": "\"[Fecal microbiota transplantation](https://www.edgepedia.org/fecal-microbiota-transplantation)\", Edgepedia (EdgeChat), [https://www.edgepedia.org/fecal-microbiota-transplantation](https://www.edgepedia.org/fecal-microbiota-transplantation). [Edgepedia Community License 1.0](https://www.edgepedia.org/edgepedia/license).",
 "credit_html": "\"<a href=\"https://www.edgepedia.org/fecal-microbiota-transplantation\">Fecal microbiota transplantation</a>\", Edgepedia (EdgeChat), <a href=\"https://www.edgepedia.org/fecal-microbiota-transplantation\">https://www.edgepedia.org/fecal-microbiota-transplantation</a>. <a href=\"https://www.edgepedia.org/edgepedia/license\">Edgepedia Community License 1.0</a>.",
 "speakable": "Fecal microbiota transplantation is the transfer of processed stool from a screened healthy donor into a patient's gut, curing 80–90% of recurrent C. difficile infections."
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