Fecal microbiota transplantation (FMT) versus conventional treatment in Clostridioides difficile antibiotic-associated diarrhea

Juliana Stupnik and Gerardo Laube

SCT Proceedings in Interdisciplinary Insights and Innovations, 2025, vol. 3, 10.56294/piii2025566

Abstract: Introduction: Antibiotic-associated diarrhea (AAD) is a common side effect resulting from altered intestinal flora, allowing the proliferation of pathogens such as Clostridioides difficile. This bacterium is responsible for pseudomembranous colitis, an increasing hospital-acquired disease related to antibiotic use and more virulent strains. Treatment of C. difficile colitis requires discontinuation of the antibiotics that trigger the infection, as the use of additional antimicrobials can be detrimental, especially in patients with multiple comorbidities. Fecal microbiota transplantation (FMT) has been positioned as a promising treatment for C. difficile colitis by restoring microbial diversity in the colon, eliminating the bacteria and reducing recurrence rates. systematic review of observational, descriptive and retrospective scientific papers published between 2018 and 2024, with the aim of evaluating the effectiveness of fecal microbiota transplantation versus refractory antibiotic treatment in cases of pseudomembranous colitis due to Clostridioides difficile. Of the 10 articles used to prepare the trial, the results of 4 of them were compared. The data reveal a greater efficacy of TMF in Clostridioides difficile colitis against conventional treatment, demonstrating a decrease in adverse effects and mortality rate, greater efficacy and lower disease recurrence. Fecal microbiota transplantation (FMT) is a superior treatment to antibiotics for Clostridioides difficile colitis, as it restores the microbial diversity of the intestine, eliminating the infection and preventing recurrences. Unlike antibiotics, which can cause dysbiosis and increase the risk of relapse, TMF shows higher success rates and is especially beneficial for patients with comorbidities. Although its initial cost is higher, the long-term savings from fewer hospitalizations and relapses make it a more cost-effective option.

Date: 2025
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