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Updated: Sep 30, 2025
Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
Published on: December 8, 2014
Fecal Microbiota Transplantation for Refractory Clostridioides Difficile Infection Is Effective and Well Tolerated
C Nivet1, V Duhalde, M Beaurain
1Laurent Alric, Internal medicine department of digestive disease, Rangueil hospital, Toulouse 3 university, 1 avenue du professeur Jean-poulhès, TSA 50032, 31000 Toulouse, France, alric.l@chu-toulouse.fr.
Objectives:
Fecal microbiota transplantation (FMT) is an innovative therapy indicated for the treatment of recurrent Clostridioides difficile infections. Although CDI and its complications are more common in very old patients (≥80 years) due to their comorbidities, frailty and senescence of the immune system, limited data are available for this older patient population.
Design:
This was a single-center, real-life cohort study with retrospective outcome data registration, conducted at Toulouse, France.
Setting And Participants:
Older people group was compared to the control group aged 18-79 years.
Measurements:
The primary outcome was overall survival at 52 weeks for ≥80 years patients compared to the control group after FMT. Recurrence-free survival at 52 weeks and, the occurrence of adverse events in the short and long term were the secondary endpoints.
Results:
A total of 58 patients were included, 19 were aged ≥80 years and 39 were aged 18-79 years. Overall survival at 52 weeks after FMT of the very old patients was not different from the control group (78.9% versus 89.7%, p= 0.29). Recurrence-free survival of CDI was not different between groups, with 94.3% in the 18-79-group versus 86.9% in the ≥80 group (p=0.44). The occurrence of short- or long-term adverse events was not statistically different between the two groups (36.8% vs 41%, p=0.45).
Conclusions:
FMT is effective and well-tolerated in very old frail patients. This treatment brings a rapid benefit and limits the loss of functions. It also favors their maintenance at home or in a non-medical institution dedicated to dependent subjects and improves their quality of life.
Insights
Fecal microbiota transplantation (FMT) is safe and effective for very old patients with recurrent Clostridioides difficile infections (CDI). This therapy demonstrates comparable survival and recurrence rates to younger adults, improving quality of life.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Geriatrics
Background:
- Recurrent Clostridioides difficile infections (CDI) pose significant risks, especially in elderly individuals (≥80 years) with comorbidities.
- Limited data exist on the efficacy and safety of Fecal Microbiota Transplantation (FMT) in this vulnerable, very old patient population.
Purpose of the Study:
- To evaluate the effectiveness and safety of FMT in patients aged 80 years and older with recurrent CDI.
- To compare outcomes, including overall survival and recurrence-free survival, between very old patients and a younger control group.
Main Methods:
- A single-center, real-life cohort study retrospectively analyzed data from 58 patients undergoing FMT.
- The study compared 19 patients aged ≥80 years with 39 patients aged 18-79 years.
- Primary outcome was 52-week overall survival; secondary outcomes included 52-week recurrence-free survival and adverse events.
Main Results:
- Overall survival at 52 weeks was comparable between the very old (78.9%) and control groups (89.7%, p=0.29).
- Recurrence-free survival at 52 weeks was also similar (86.9% vs 94.3%, p=0.44).
- Short- and long-term adverse events did not significantly differ between the groups (41% vs 36.8%, p=0.45).
Conclusions:
- Fecal microbiota transplantation (FMT) is an effective and well-tolerated treatment for very old, frail patients with recurrent CDI.
- FMT offers rapid benefits, helps maintain function, and supports continued independence or institutional care, improving quality of life.
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