**EMBARGOED All research presented at the ACG Annual Scientific Meeting is strictly embargoed until Monday, October 19, 2015 at 8 AM (EDT).
Poster 1495 Management and Outcomes of Patients with Failed Fecal Microbiota Transplantation for Recurrent Clostridium difficile Infection
Author Insight from Sahil Khanna, MBBS, MS, Mayo Clinic, Rochester, MN
What’s new here and important for clinicians?
C. difficile-infected patients are at a high risk of recurrent infection: 20% after the first infection and 60% after the third infection. Data on management and clinical sequelae of patients who have recurrent CDI after FMT are scarce. In this study, we reported our single-center tertiary care experience on post-FMT treatment and outcomes of patients with failed FMT. After a median follow-up of 61.4 weeks (range 4-147 weeks), of the 238 rCDI patients who underwent FMT, the rate of FMT failure was 10.5%. Amongst these patients, 33% had underlying IBD. Among FMT failures, post-FMT, 16% had minimal symptom improvement after FMT and were early failures. The median time to recurrent CDI after FMT was 19.5 weeks (range 1.4-152 weeks) with 90% patients recurring within 68 weeks. Patients with recurrent CDI after FMT were commonly exposed to systemic antibiotics (60%) leading to FMT failure, and 33% had underlying IBD, which appeared to be a risk factor in the absence of antibiotic exposure. These patients were managed with repeat course of antibiotics or repeat fecal transplant (20%).
What do patients need to know?
C. difficile-infected patients are at a high risk of complications such as recurrent infection. Management options for recurrent infection include antibiotic therapy, but results are dismal. Fecal microbiota transplantation (FMT) is a safe and effective treatment for recurrent Clostridium difficile infection with success rates >85%. Data on management and clinical sequelae of patients who have recurrent CDI after FMT are scarce. The rate of recurrent CDI was 10% in patients after FMT, and most common reasons included repeat antibiotic exposure and underlying inflammatory bowel disease. Patients with FMT failure can be managed with antibiotics or repeat FMT.
Author Contact Sahil Khanna, MBBS, MS, Mayo Clinic, Rochester, MN
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