To evaluate the real-world clinical and safety outcomes of fecal microbiota transplantation (FMT) for recurrent, refractory, and/or severe or fulminant Clostridioides difficile infection (CDI) in South Australia, highlighting its significance in improving treatment options.
Key Findings:
98 potential donors passed prescreening; 61 (62%) were eligible after laboratory screening. A total of 220 cases of CDI were treated. Primary cure rate for CDI was 84% overall, with 88% for recurrent CDI and 65% for fulminant disease. Serious adverse events occurred in 3% of patients, with no deaths directly attributable to FMT.
Interpretation:
FMT is a safe and effective treatment for recurrent and refractory CDI in a real-world setting, with significant implications for clinical practice, but further studies are needed to optimize its use for severe and fulminant cases.
Limitations:
Data collection was limited to a specific geographic region (South Australia), which may affect generalizability. The study did not control for FMT delivery methods or volumes, potentially impacting outcomes.
Conclusion:
FMT demonstrates high efficacy and safety for managing recurrent and refractory CDI, warranting further investigation for severe cases to enhance treatment strategies.
