Faecal microbiota transplantation for primary Clostridioides difficile infection

Area of Science:

• Microbiology
• Gastroenterology
• Infectious Diseases

Background:

• Clostridioides difficile infection (CDI) is a significant healthcare concern.
• Antibiotics are the standard treatment for primary CDI.
• Faecal microbiota transplantation (FMT) is established for recurrent CDI.

Purpose of the Study:

• To present a case of primary CDI where the patient requested FMT.
• To explore the evaluation of experimental treatments against guideline recommendations.
• To highlight the role of patient preference in treatment decisions.

Main Methods:

• A patient with primary CDI refused standard antibiotic therapy.
• The patient received FMT outside of guideline recommendations.
• Treatment outcomes were monitored for symptom remission.

Main Results:

• The patient experienced complete remission of CDI symptoms within two days of FMT.
• This outcome occurred despite FMT not being indicated for primary CDI at the time.
• The case demonstrates successful management aligning with patient preference.

Conclusions:

• Patient preferences and emerging evidence can challenge established treatment guidelines.
• Careful evaluation is needed when considering off-label or experimental therapies.
• Shared decision-making is crucial in complex clinical scenarios like primary CDI management with FMT.