In conclusion, stool transplantation is a safe and effective clinical
treatment option for patients suffering from RCDI. Advantages of this
treatment include its high cure rates, and the reliance on “the ultimate
probiotic” e healthy stool flora e for restoring intestinal microbiota
and colonization resistance. Even though the cost of FMT at present
includes the cost of laboratory screening of the stool donors, the
overall cost will likely be far lower than the costs for alternative
therapies, which include repeated hospitalizations and treatment
courses with expensive antibiotic agents. If the costs of laboratory
screening of donors could be reduced or eliminated, FMT could be
made financially more accessible to a wider range of patients.
4.1. Study limitations
This study was a retrospective examination of an uncontrolled
series of cases treated at a single institution. In some cases, eligibility
for inclusion in the case series was based on clinical and laboratory
data from referring institutions; photocopies of medical and laboratory
records were obtained for referred patients, but the quality of the
data could not be confirmed. Some patients were lost to follow up
after they initially had resolved their diarrhea, thus, durable resolu-
tion of CDI was assumed but could not be confirmed. Each patient
who was included in this case series essentially served as his or her
owncontrol by having failed to resolve RCDI after repeated courses of
standard antibiotic treatment. However, without a concurrent
control group, the conclusions that can be drawn regarding the efficacy
of the treatment are limited. Additional studies will be needed
before the results can be generalized for broader clinical use.