Real-world Efficacy of Fecal Microbiota Transplantation for All C difficile Infection Subtypes: 81% for Recurrent, 78% for Refractory, 71% for Severe

Colorectal

Douglas K. Rex, MD, MASGE reviewing Osman M, et al. Gastroenterology 2022 Apr 7.

This report describes a 4-year prospective, observational assessment of fecal microbiota transplantation (FMT) performed in 681 health care facilities across 50 U.S. states and 7 countries in 5344 patients with C difficile infection (CDI). The subtype of CDI with the highest cure rate was recurrent CDI with a cure rate of 81%, followed by 78% for refractory CDI and 71% for severe CDI.

There were also differences in results depending on the FMT delivery method. The success rates were 81% with lower GI delivery, 70% with upper GI tube delivery by endoscopy or nasoenteric tube, and 71% with frozen oral capsules.

Comment:

These data indicate that lower GI delivery of FMT remains the most effective route of administration.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

Douglas K. Rex, MD, MASGE

Bio and Disclosures

Citation(s):

Osman M, Budree S, Kelly CR, et al. Effectiveness and safety of fecal microbiota transplantation for Clostridioides difficile infection: results from a 5,344 patient cohort study. Gastroenterology 2022 Apr 7. (Epub ahead of print) (https://doi.org/10.1053/j.gastro.2022.03.051)