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Advisor(s)
Abstract(s)
Introdução: A infeção por Clostridium difficile (ICD) afirma-se como um dos grandes desafios
em saúde pelo aumento da sua incidência, severidade e custos económicos associados. A falta
da eficácia dos tratamentos standard face à recorrência da ICD, emerge a necessidade de
melhores alternativas na gestão e tratamento desta condição, em que o transplante fecal (FMT)
apresenta resultados promissores. O FMT traduz-se no transplante de microrganismos
intestinais (de uma suspensão de fezes de um doador saudável) no intestino do paciente de
forma a restaurar a microbiota. Esta opção terapêutica tem sido cada vez mais utilizada como
“terapia de resgate” face à ineficácia do tratamento com a antibioterapia e à elevada
morbilidade e mortalidade associada à ICD recorrente. A presente dissertação procura indagar
assim, sobre a opção do FMT no tratamento da ICD recorrente.
Métodos: Procedeu-se à realização de uma revisão bibliográfica, com recurso à pesquisa de
publicações indexadas na base eletrónica científica, Pubmed, sem restrição do período
temporal de publicação.
Resultados: Dos 393 artigos, selecionaram-se 16 para análise: 2 estudos prospetivos e 14 séries
de casos. Todas as publicações reportam níveis elevados de eficácia do FMT no tratamento da
ICD recorrente, com valores a variar entre 79% e 100%. Foi identificado apenas um ensaio clínico
randomizado (RCT) que demonstrou existir uma taxa de cura estatisticamente superior com a
utilização do FMT comparativamente com a terapêutica standard (antibioterapia).
Conclusão: O FMT é reconhecido cada vez mais como opção terapêutica no tratamento da ICD
recorrente, apresentando níveis de eficácia mais elevados comparativamente com a
antibioterapia. Os níveis elevados obtidos na resolução da ICD recorrente tornam o FMT numa
opção terapêutica cada vez mais válida no seio da comunidade médica e científica.
Background: Clostridium difficile infection (CDI) is stated as a major challenge in health because of its incidence increasing, severity and associated economic costs. From the lack of efficacy of standard treatments, due to the recurrence of the CDI, emerges the need of better alternative in the management and treatment of this condition, where fecal microbiota transplantation (FMT) shows promising results. The FMT implies the transplant of intestinal microorganisms (from a suspending faeces of a healthy donor) on the patient's intestine in order to restore microbiota. This therapeutic option has been increasingly used as a "rescue therapy" over the inefficiency of treatment with antibiotics and high morbidity and mortality associated with recurrent CDI. This dissertation seeks to inquire on the FMT option in the treatment of recurrent CDI. Methods: It was carried out the implementation of a bibliographic review, considering the use of research publications indexed in the scientific electronic database, Pubmed, without restricting the time period of publication. Results: Out of the 393 articles, 16 were selected for analysis: 2 experimental studies and 14 case series. All publications report high levels of FMT efficacy in the treatment of recurrent CDI, with values varying between 79% and 100%. It was identified only one randomized clinical trial (RCT) which results showed that there is a statistically higher cure rate using the FMT compared with standard therapy (antibiotics). Conclusions: The FMT is increasingly recognized as a treatment option in the recurrent CDI treatment, with higher performance levels compared with antibiotic therapy. Resolution´s high levels obtained in recurrent CDI, make the FMT as a therapeutic option with increasing value within the medical and scientific community.
Background: Clostridium difficile infection (CDI) is stated as a major challenge in health because of its incidence increasing, severity and associated economic costs. From the lack of efficacy of standard treatments, due to the recurrence of the CDI, emerges the need of better alternative in the management and treatment of this condition, where fecal microbiota transplantation (FMT) shows promising results. The FMT implies the transplant of intestinal microorganisms (from a suspending faeces of a healthy donor) on the patient's intestine in order to restore microbiota. This therapeutic option has been increasingly used as a "rescue therapy" over the inefficiency of treatment with antibiotics and high morbidity and mortality associated with recurrent CDI. This dissertation seeks to inquire on the FMT option in the treatment of recurrent CDI. Methods: It was carried out the implementation of a bibliographic review, considering the use of research publications indexed in the scientific electronic database, Pubmed, without restricting the time period of publication. Results: Out of the 393 articles, 16 were selected for analysis: 2 experimental studies and 14 case series. All publications report high levels of FMT efficacy in the treatment of recurrent CDI, with values varying between 79% and 100%. It was identified only one randomized clinical trial (RCT) which results showed that there is a statistically higher cure rate using the FMT compared with standard therapy (antibiotics). Conclusions: The FMT is increasingly recognized as a treatment option in the recurrent CDI treatment, with higher performance levels compared with antibiotic therapy. Resolution´s high levels obtained in recurrent CDI, make the FMT as a therapeutic option with increasing value within the medical and scientific community.
Description
Keywords
Clostridium Difficile Infeção Recorrente Microbiota Transplante Fecal