FMT prevents recurrent C. difficile infection in IBD patients

Patients with inflammatory bowel disease (IBD) who undergo foecal microbiota transplantation (FMT) are less likely to develop recurrent Clostridioides difficile infection (CDI), a study has shown.

The authors conducted a systematic search of several databases such as Embase, Scopus, and Web of Science. Their analysis targeted the pooled rate of CDI resolution following single and multiple FMTs in IBD patients. They performed additional analyses for the rates of IBD-related outcomes (eg, flare, surgery, symptom improvement) after FMT. Pooled rates were calculated using a random-effects model.

Of the 457 adult patients identified, 363 had CDI resolution following the first FMT (pooled cure rate, 78 percent, 95 percent confidence interval [CI], 73‒83; I², 39 percent). The overall pooled cure rate with single and multiple FMTs was 88 percent (95 percent CI, 81‒94; I², 73 percent).

The pooled rates of an IBD flare after FMT and of colectomy were 26.8 percent (95 percent CI, 22.5‒31.6; I², 9 percent) and 7.3 percent (95 percent CI, 4.7‒10.5; I², 56 percent), respectively.

Among 141 paediatric patients, 106 had CDI resolution following the first FMT (pooled cure rate, 78 percent, 95 percent CI, 58‒93; I², 59 percent). The overall pooled cure rate with single and multiple FMTs was 77 percent (95 percent CI, 50‒96; I², 63 percent).

The corresponding pooled rates of an IBD flare after FMT and of colectomy were 10.8 percent (95 percent CI, 5.7‒18.5; I², 43 percent) and 10.3 percent (95 percent CI, 2.1‒30.2; I², 23 percent).

“Patients who fail a single FMT may benefit from multiple FMTs,” the authors said.