GOAL: By systematic review, we assessed the impact of fecal microbiota 
transplantation (FMT) for the treatment of Clostridium difficile (CD)-associated 
diarrhea.
BACKGROUND: Fecal microbiota microbiota transplantation from a healthy donor 
into an individual with CD infection (CDI) can resolve symptoms.
STUDY: We conducted systematic searches in PubMed, SCOPUS, Web of Science, and 
Cochrane Library. The last search was run on February 8, 2013. The following 
Medical Subject Headings terms and keywords were used alone or in combination: 
Clostridium difficile; Clostridium infection; pseudomembranous colitis; feces; 
stools; fecal suspension; fecal transplantation; fecal transfer; fecal infusion; 
microbiota; bacteriotherapy; enema; nasogastric tube; colonoscopy; gastroscopy; 
fecal donation; donor. A critical appraisal of the clinical research evidence on 
the effectiveness and safety of FMT for the treatment of patients with 
CD-associated diarrhea was made.
RESULTS: Twenty full-text case series, 15 case reports, and 1 randomized 
controlled study were included for the final analysis. Almost all patients 
treated with donors' fecal infusion experienced recurrent episodes of 
CD-associated diarrhea despite standard antibiotic treatment. Of a total of 536 
patients treated, 467 (87%) experienced resolution of diarrhea. Diarrhea 
resolution rates varied according to the site of infusion: 81% in the stomach; 
86% in the duodenum/jejunum; 93% in the cecum/ascending colon; and 84% in the 
distal colon. No severe adverse events were reported with the procedure.
CONCLUSIONS: FMT seems efficacious and safe for the treatment of recurrent CDI. 
Hospitals should encourage the development of fecal transplantation programs to 
improve therapy of local patients.