In critically ill sepsis patients on broad-spectrum antibiotics, daily fecal microbiota transplantation for six days preserves gut microbial diversity, increases Bacteroides, and decreases Enterobacteriaceae compared to probiotics or no intervention.
See the scientific wording
In critically ill sepsis patients receiving broad-spectrum antibiotics, a single course of fecal microbiota transplantation (FMT) administered daily for six days significantly preserves gut microbial alpha diversity as measured by the Chao1 index (p=0.0125), increases the relative abundance of Bacteroides, and reduces the relative abundance of Enterobacteriaceae compared to probiotics or no intervention.
Very strong evidence
Randomized trialsOne good-quality study supports this claim.
What the research says
1 study reviewedSupporting (1)
Randomized Controlled TrialHuman2026
In very sick sepsis patients on strong antibiotics, a week of fecal transplant helped keep their gut bacteria healthy and balanced—boosting good bacteria and cutting bad ones—while probiotics didn’t help at all.
Contradicting (0)
No contradicting studies found yet
That doesn't mean it's settled — it just means no study has tested the opposite.
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A diverse mix of healthy gut bacteria from a donor is introduced into the gut, where these bacteria take hold and outcompete harmful bacteria that have grown unchecked after antibiotics. The healthy bacteria use up resources and produce substances that block the harmful ones, allowing the gut to regain a balanced and stable bacterial community.
Score breakdown, mechanism chain, raw evidence, ideal studies needed & 1 supporting study
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In critically ill sepsis patients on broad-spectrum antibiotics, daily fecal microbiota transplantation for six days preserves gut microbial diversity, increases Bacteroides, and decreases Enterobacteriaceae compared to probiotics or no intervention.
Mechanism
1 studyHealthy gut bacteria from a donor take over the gut and push out harmful bacteria that grew after antibiotics. This restores balance and keeps the gut microbiome diverse and stable. Probiotics don't work because they can't survive or compete under antibiotic pressure.
A diverse mix of healthy gut bacteria from a donor is introduced into the gut, where these bacteria take hold and outcompete harmful bacteria that have grown unchecked after antibiotics. The healthy bacteria use up resources and produce substances that block the harmful ones, allowing the gut to regain a balanced and stable bacterial community.
A suspension of viable, diverse gut microbes from a healthy donor is delivered directly into the intestine.
Donor-derived keystone taxa, including Bacteroides, successfully colonize the gut and establish stable populations despite ongoing antibiotic exposure.
Engrafted beneficial bacteria outcompete opportunistic pathogens such as Enterobacteriaceae for nutrients and physical space in the gut lumen.
Beneficial bacteria produce metabolites that inhibit the growth and virulence of pathogenic bacteria.
The restored microbial community reestablishes colonization resistance, preventing pathogen expansion and stabilizing overall microbial diversity.
Evidence from Studies
Supporting (1)
Community contributions welcome
Effects of fecal microbiota transplantation and probiotics on the gut microbiome in antibiotic-treated septic patients: A pilot randomized controlled trial
In very sick sepsis patients on strong antibiotics, a week of fecal transplant helped keep their gut bacteria healthy and balanced—boosting good bacteria and cutting bad ones—while probiotics didn’t help at all.
Contradicting (0)
Community contributions welcome
Score Breakdown
No multi-axis breakdown available yet. The overall Pro / Against score above is the best signal.
- No clinical evidence is available; the score reflects mechanistic plausibility only.
What Would Prove This
Per GRADE and EBM methodology, here is what ideal scientific evidence would look like to definitively prove or disprove this claim, ordered from strongest to weakest.
Systematic Review and Meta-Analysis of Fecal Microbiota Transplantation for Gut Microbial Diversity in Critically Ill Sepsis Patients on Antibiotics
Population: Critically ill sepsis patients on broad-spectrum antibiotics; Intervention: Daily FMT for six days; Comparator: Probiotics or no intervention; Outcomes: Chao1 index, relative abundance of Bacteroides and Enterobacteriaceae; Duration: At least 14 days post-intervention.
Double-Blind Randomized Controlled Trial of Daily FMT vs Probiotics vs No Intervention on Gut Microbial Diversity in Critically Ill Sepsis Patients
Population: Critically ill sepsis patients on broad-spectrum antibiotics; Intervention: Daily FMT for six days; Comparator: Probiotics and no intervention; Outcomes: Chao1 index, relative abundance of Bacteroides and Enterobacteriaceae at baseline, day 6, and day 14; Duration: 14 days with follow-up.
Prospective Cohort Study Comparing Gut Microbial Dynamics in Critically Ill Sepsis Patients Receiving FMT, Probiotics, or No Intervention
Population: Critically ill sepsis patients on broad-spectrum antibiotics; Intervention: FMT, probiotics, or no intervention as clinically assigned; Outcomes: Chao1 index, Bacteroides and Enterobacteriaceae abundance measured at multiple time points; Duration: 14–28 days.
Case-Control Study of Patients with Preserved vs Reduced Gut Microbial Diversity After FMT in Critically Ill Sepsis
Population: Critically ill sepsis patients on broad-spectrum antibiotics; Cases: Patients with preserved Chao1 index and increased Bacteroides; Controls: Patients with reduced diversity and increased Enterobacteriaceae; Exposure: FMT administration; Duration: Retrospective analysis of microbial data collected during ICU stay.
In Vitro Microbial Community Response to FMT Donor Material in Simulated Gut Environment of Sepsis-Exposed Microbiota
Population: Human fecal microbiota from healthy donors and sepsis patients; Intervention: Exposure to FMT material in anaerobic bioreactors with broad-spectrum antibiotics; Outcomes: Changes in alpha diversity and relative abundance of Bacteroides and Enterobacteriaceae; Duration: 72–120 hours.