Fecal Microbiota Transplantation Might Prevent Clostridioides difficile infection in IBD Patients

Studies have shown that FMT is a safe and effective therapy for recurrent Clostridioides difficile infection. However, data on FMT for CDI in patients with underlying IBD are emerging but conflicting. Therefore, Dr Sahil Khanna and his team conducted a study to evaluate the efficacy and safety of FMT for CDI in IBD and its impact on IBD outcomes.

The researchers conducted a systemic review of multiple databases including Embase, Scopus, and Web of Science. They focused on the pooled rate of CDI resolution after single and multiple FMTs in IBD patients. They assessed the rates of IBD-associated outcomes (flare, surgery, symptom improvement) after FMT. They used the random-effects model to calculate pooled rates.

Key findings of the study:

• Among 457 adult patients, the researchers observed 363 had CDI resolution after first FMT with a pooled cure rate of 78%.
• They noted that the overall pooled rate cure rate with single and multiple FMTs was 88%.
• They found that the pooled rate of an IBD flare after FMT was 26.8% and of colectomy was 7.3%.
• Among 141 pediatric patients, they noted that 106 had CDI resolution after first FMT with a pooled cure rate of 78%.
• They also noted that the overall pooled cure rate with single and multiple FMTs was 77%.
• They further found that the pooled rate of an IBD flare after FMT was 10.8%, and of colectomy was 10.3%.

The authors concluded, "FMT appears to be a highly effective therapy for preventing recurrent CDI in patients with IBD. Patients who fail a single FMT may benefit from multiple FMTs."

For further information:

DOI: 10.1097/MCG.0000000000001633