The need to move away from fecal transplant towards targeted, refined microbiome therapy.

Abstract

The recent editorial entitled “ Microbiota replacement for Clostridium difficile by capsule is as effective as via colonoscopy ” by Saha & Khanna provides an excellent review of the clinical efficacy, as well as the delivery options, for fecal microbiota transplantation (FMT) for patients suffering from a recurrent, C. difficile infection (rCDI) (1). The review also highlights the uncertainty that is relating to the optimal dose, or the delivery route for FMT (1). Admittedly, FMT is a crude and archaic method, with many drawbacks despite the high efficacy and lack of short term safety concerns. The long-term consequences remain to be determined, as the potentials for transferring infectious agents, or donor traits such as obesity, exist.