Oral, frozen fecal microbiota transplant (FMT) capsules for recurrent Clostridium difficile infection

Autor: Jess L. Kaplan, Jasmin Mahabamunuge, Joanne Levin, Ilan Youngster, Hannah Systrom, Hamed Khalili, Elizabeth L. Hohmann, Jenny Sauk
Jazyk: angličtina
Předmět:
Male
Antibiotics
Administration
Oral
Pilot Projects
Fecal microbiota transplant
Feces
0302 clinical medicine
Oral administration
Recurrence
Freezing
Clinical endpoint
030212 general & internal medicine
Child
Aged
80 and over
Medicine(all)
Microbiota
General Medicine
Clostridium difficile
Fecal Microbiota Transplantation
Middle Aged
3. Good health
Anti-Bacterial Agents
Treatment Outcome
Cohort
030211 gastroenterology & hepatology
Female
Research Article
Adult
medicine.medical_specialty
Adolescent
medicine.drug_class
Capsules
03 medical and health sciences
Young Adult
Refractory
Internal medicine
Drug Resistance
Bacterial
medicine
Humans
Adverse effect
Aged
Retrospective Studies
business.industry
Clostridioides difficile
Immunology
Clostridium Infections
Feasibility Studies
Microbiome
business
Zdroj: BMC Medicine
ISSN: 1741-7015
DOI: 10.1186/s12916-016-0680-9
Popis: Background Fecal microbiota transplantation (FMT) has been shown to be safe and effective in treating refractory or relapsing C. difficile infection (CDI), but its use has been limited by practical barriers. We recently reported a small preliminary feasibility study using orally administered frozen fecal capsules. Following these early results, we now report our clinical experience in a large cohort with structured follow-up. Methods We prospectively followed a cohort of patients with recurrent or refractory CDI who were treated with frozen, encapsulated FMT at our institution. The primary endpoint was defined as clinical resolution whilst off antibiotics for CDI at 8 weeks after last capsule ingestion. Safety was defined as any FMT-related adverse event grade 2 or above. Results Overall, 180 patients aged 7–95 years with a minimal follow-up of 8 weeks were included in the analysis. CDI resolved in 82 % of patients after a single treatment, rising to a 91 % cure rate with two treatments. Three adverse events Grade 2 or above, deemed related or possibly related to FMT, were observed. Conclusions We confirm the effectiveness and safety of oral administration of frozen encapsulated fecal material, prepared from unrelated donors, in treating recurrent CDI. Randomized studies and FMT registries are still needed to ascertain long-term safety.
Databáze: OpenAIRE
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