the laboratory.
"The ultimate goal is to move away from the need for trans-
plants, so we know exactly what we're putting into patients and
can virtually eliminate any possibility of inadvertently transmit-
ting disease," says Dr. Lewis.
Researchers are getting closer. The ability to identify microscopic
species has dramatically improved over the last decade, thanks to
modern sequencing technology that can identify species based on
their DNA, instead of having to culture them. "But there are undoubt-
edly bacteria we haven't yet identified," says Dr. Lewis, "and those
could be a concern."
Despite the unknowns, Dr. Lewis strongly believes that there are
patients for whom fecal microbiota transplantation is appropriate
treatment, especially when one considers the potentially devastat-
ing consequences of C. diff infections. And he encourages patients
and providers to participate in one or more of the registries that are
collecting long-term data, such as the American Gastroenter-ologi-
cal Association FMT Registry (osmag.net/go4wje), to understand
what, if any, long-term impact transplants may have.
OSM
A U G U S T 2 0 1 7 • O U T PA T I E N TS U R G E R Y. N E T • 1 1 1
Administering a targeted and relatively small amount of narrow-
spectrum antibiotics is safer than carpet-bombing with an arse-
nal of broad-spectrum drugs. Unless you're dealing with a
known infection, narrow-spectrum antibiotics geared toward the
specific bacteria associated with particular areas of the body are
usually enough to decrease the risk of infection.
• Be wary of post-op administration. There's very little data to
suggest that post-operative antibiotics are needed in most
cases. It's when the incision is happening that antibiotics really
need to be present. — Jim Burger