An infusion of faeces from a healthy person stops the recurrence of Clostridium difficile infections,which can cause severe diarrhoea.

Faecal transplants  —  in which faeces from one person is infused into another's intestines  —  have dramatically outperformed a conventional antibiotic at treating recurring infections ofClostridium difficile, a bacterium that causes severe diarrhoea.

This marks the first time that the unorthodox technique has proven its effectiveness in a randomized clinical trial, in which patients are randomly assigned to groups that are treated with different therapies. The transplants were so successful that the trial was stopped early. The results are published today in the New England Journal of Medicine1.

Faecal transplants are meant to restore the healthy complement of gut bacteria that would normally keep C. difficile at bay. Despite their unappealing nature, the transplants have been used to treat hundreds of patients, more than 90% of whom have recovered.

Hard sell

“Those of us who’ve been doing this procedure for some time didn’t need any more convincing, but the large medical community needs to go through these steps,” says Alexander Khoruts, a gastroenterologist at the University of Minnesota in Minneapolis, who was not involved in the trial. “It’s an unusual situation where we have more than 50 years of worldwide experience and more than 500 published cases, and only this far along does a randomized trial appear.”

Els van Nood, an internal medicine researcher at the University of Amsterdam and a co-author of the study, says that doctors and patients are sometimes reluctant to try the technique. But we had so many recurrences that couldn’t be cured, and when we started faecal therapy, it worked amazingly,” she says. “We didn’t have trouble in convincing our ethical commission to start the trial.