Feces transplantation – EU recommendations

R ecurrent Clostridium difficile infection (CDI) exhibits a disrupted diverse gut microbiome where recolonization decides the final outcome of this often challenging course of disease. Clinical trial and error treatment with fecal microbiota transplant (FMT) have until recently produced limited amount of scientific data. Lack of a standardized procedure and obscure declaration of product content have made data evaluation difficult. Lately, a randomized controlled study has proven FMT to be superior to standard vancomycin therapy, inspiring several ongoing studies. The European guidelines published by the European Society of Clinical Microbiology and Infectious Diseases (1) has evidenced that FMT is now an acceptable mode of treatment. This discussion will highlight the current position of FMT in treatment, the slowly emerging consensus on different procedures in practice, as well as the concerns that are still prevalent.