Management of Severe and Severe/Complicated Clostridoides difficile Infection Using Sequential Fecal Microbiota...

Area of Science:

• Gastroenterology
• Infectious Diseases
• Microbiology

Background:

• Clostridoides difficile infection (CDI) poses a significant challenge, particularly severe or complicated cases unresponsive to standard antibiotic therapy.
• Recurrent CDI necessitates exploring alternative and effective treatment strategies.

Purpose of the Study:

• To evaluate the efficacy and safety of serial fecal microbiota transplant (FMT) administered via retention enema for patients with refractory severe or severe/complicated CDI.

Main Methods:

• A cohort of 15 patients with severe/complicated CDI, failing at least 48 hours of antibiotics, received serial FMT by retention enema.
• Patient outcomes, including sustained cure at 30 days and adverse events, were monitored.

Main Results:

• Initial clinical improvement was observed in the majority of patients following FMT.
• However, only 5 out of 15 patients achieved a sustained cure at the 30-day follow-up.
• Four patients experienced serious adverse events during the study period.

Conclusions:

• Serial FMT via retention enema demonstrates potential for initial symptom relief in severe CDI.
• The treatment shows limited efficacy in achieving sustained cure rates at 30 days for this patient population.
• Further research is warranted to optimize FMT protocols and assess long-term safety for refractory CDI.