Fecal microbiota transplantation: indications and perspectives

Fecal transplantation demonstrated in a randomized trial its superiority compared to antibiotics in recurrent Clostridium difficile (CD) infections. Used in first-line treatment, it has reduced the mortality of patients suffering of CD infections caused by ribotype 027 and made it possible to cure patients with severe manifestations of CD infections caused by other ribotypes. The use of frozen microbiota, now validated, facilitates fecal microbiota transplantation. In addition, the frozen microbiota capsules have proven their efficiency. Other indications such as the digestive decolonization of multidrug-resistant bacteria are emerging. Finally, a better knowledge of the gastrointestinal microbiota will lead in the future to new targeted therapies in many indications.