Faecal microbiota transplant safe, effective for recurrent CDI

Faecal microbiota transplantation (FMT) may be an effective intervention for recurrent Clostridioides difficile infection (CDI), leading to high clinical cure and low complication rates, reports a new real-world study.

The study included 5,344 CDI patients who had received FMT as a treatment. Overall, the clinical cure rate was 78 percent, spanning all physician-reported outcomes, delivery modalities, and CDI types. Of all infection subtypes, recurrent CDI saw the largest benefit, with a clinical cure rate of 81 percent.

Meanwhile, lower delivery was found to be the most effective route of administration, yielding a cure rate of 81 percent.

In terms of safety, the researchers reported a favourable profile, especially given that the patient population was medically complex with traditionally poor outcomes. Only 194 patients (3.6 percent) experienced one or more serious adverse events (SAEs), which were found to occur most commonly among those with severe-complicated CDI (48.5 percent).

Of all SAEs reported, only six (0.1 percent) were deemed to be possibly related to FMT, all of which arose in severely immunocompromised patients. No SAEs were determined to be related to FMT. There were also no cases of sepsis, infections transmitted through FMT, and multidrug resistant organism-related infections.

“To our knowledge, this is the largest FMT cohort reported and suggests that in a real-world cohort, FMT from a stool bank may be a safe and effective treatment for CDI not responsive to standard of care,” the researchers said.

However, several limitations point to the need for further studies. These included the lack of a control group, potential variations in the timing of physician-reported outcomes, misdiagnosis of CDI, and the possibility of a placebo effect.