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?difficile. Both are designed to enhance host protection against CDI, the first by restoring colonization resistance and the second by supplementing deficiencies in the patient��s adaptive immune response to C.?difficile. Most evidence for the benefit of FMT, in which donor faeces from a healthy individual are transplanted into the colon of a CDI patient, as a treatment for multiple-recurrent CDI has come from single-centre case series and case studies and is based on small numbers of patients [38]. However, a recent report from a multicentre, long-term follow-up study in a much larger number of patients www.selleckchem.com/products/epz-5676.html (n?=?77) who received FMT for refractory CDI has also shown encouraging results, with 74% of patients experiencing a resolution of diarrhoea within 3?days of treatment [38]. Given practical considerations related to material preparation and administration of donor faeces, as well as aesthetic concerns and potential risks of transmitting pathogens, for the time being FMT is likely to remain a reserve therapy for patients who experience multiple recurrences and for whom other treatments have failed. Failure to mount an effective immunoglobulin (Ig)G-mediated antibody response to C.?difficile toxins differentiates patients with CDI from those asymptomatically colonized with C.?difficile [39]. Passive immunotherapy, in which patients receive an infusion of antibodies specific to C.?difficile toxins, aims to aid patients who have failed to increase their adaptive LY2109761 immune response to C.?difficile toxins. Although data are still limited, a phase 2 trial of infused human monoclonal antibodies against C.?difficile toxins A and B suggests they may have protective efficacy and help reduce the frequency MAPK of recurrence when given as an adjunct to conventional antibiotic therapy [8]. In a trial involving 200?patients with CDI, a substantial reduction in recurrence was observed in patients who received neutralizing anti-toxin monoclonal antibody therapy in addition to metronidazole or vancomycin compared with those who received conventional antibiotic therapy alone (7% vs. 25%, respectively; p?
