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Faecal microbiota transplantation as a home therapy to frail older people
Simon Mark Dahl Jørgensen1, Tone Maria Mørck Rubak2, Else Marie Damsgaard2
1Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus N, Denmark.
Background:
Clostridioides (Clostridium) difficile infection (CDI) is a leading cause of antibiotics-associated diarrhoea. Faecal microbiota transplantation (FMT) is effective for recurrent CDI and may be provided as a home treatment to frail, older people.
Methods:
We present four consecutive patients with recurrent CDI, treated at home using nasojejunal tube-delivered or encapsulated donor faeces. The primary outcome was combined clinical resolution and a negative CD toxin test 8 weeks post-treatment.
Results:
All four patients had severe CDI and all improved clinically following one FMT. Sustained resolution following one FMT was observed in one patient. Two patients had recurrence and received a second FMT using capsules; both achieved resolution. One patient who had recurrence declined from further FMT due to fear of relapse and was established on long-term vancomycin. No adverse events related to FMT were observed.
Conclusion:
Frail older people may benefit from FMT. Home treatment is a viable option and may be considered both for clinical cure and for palliation.
Insights
Faecal microbiota transplantation (FMT) effectively treats recurrent Clostridioides difficile infection (CDI) in frail older adults. Home-based FMT offers a viable option for clinical cure and palliation, with no observed adverse events.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Geriatrics
Background:
- Clostridioides difficile infection (CDI) is a significant cause of antibiotic-associated diarrhea.
- Faecal microbiota transplantation (FMT) demonstrates efficacy in treating recurrent CDI.
- Home-based FMT is a potential treatment option for elderly and frail individuals.
Purpose of the Study:
- To evaluate the effectiveness and safety of home-administered FMT for recurrent CDI in four frail older patients.
- To assess clinical resolution and negative C. difficile toxin tests at 8 weeks post-treatment.
Main Methods:
- Four consecutive patients with recurrent severe CDI received home-based FMT via nasojejunal tube or capsules.
- Treatment outcomes were assessed based on clinical improvement and C. difficile toxin test results at 8 weeks.
Main Results:
- All four patients experienced clinical improvement after the initial FMT.
- One patient achieved sustained resolution after a single FMT.
- Two patients with recurrence achieved resolution after a second FMT; one patient declined further treatment.
Conclusions:
- Home-based FMT is a viable and safe treatment option for recurrent CDI in frail older adults.
- FMT can be considered for both curative and palliative management of CDI in this population.
