The following is a summary of “Long-Term Efficacy and Safety of Fecal Microbiota Transplantation for C. difficile Infections Across Academic and Private Clinical Settings,” published in the November 2023 issue of Gastroenterology by Dogra, et al.
Fecal microbiota transplant (FMT) is being used increasingly to treat Clostridioides difficile infection (CDI), but more long-term data on its safety and effectiveness must be needed. Also, most data came from university medical centers, not private settings, where most patients get care. The medical records of 165 people who got FMTs for CDI were looked at from an academic medical center and a private practice next door that was not connected to the academic medical center. 68 patients also filled out a poll about their long-term health and illness course.
It was found that 81.3% (100/123) of the cases at the academic center were resolved, while 95.2% (40/42) of the cases in the private setting were resolved. People who went to a private office were more likely to have recurrent CDI than resistant CDI (92.9% vs. 66.7% P<0.001). People from the academic center were more likely to have IBD, have been in the hospital recently, use a proton pump inhibitor recently, be on long-term steroids, and be admitted for FMT (all P values <0.05). After an average follow-up of 33.7 months (IQR 13.2 to 44.3 mo), 29.4% of the patients surveyed had new or changed pre-existing symptoms or illnesses.
Thirty of the patients who needed more drugs had a return of CDI. All of the people who reacted to FMT at first but then had a CDI (17.9%, or 10/56) responded to another FMT. In the real world, people who had FMT at research centers were very different from those who got it at a private practice regarding their health. In both situations, FMT works well to treat CDI that doesn’t react to normal treatments, even after antibiotics have been used. However, new findings after FMT are frequent and should be investigated further.
Source: journals.lww.com/jcge/abstract/2023/11000/long_term_efficacy_and_safety_of_feal_microbiota.9.aspx