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Fecal microbiota transplantation for treatment of Clostridioides difficile infection

Fecal microbiota transplantation (FMT) refers to administration of stool bacteria into the intestinal tract of a patient with Clostridioides difficile infection (CDI) [1-4]. FMT protocols vary between institutions, and comparative efficacy studies are few and underpowered.

Available data are strongest for use of FMT in the setting of recurrent CDI; recurrent CDI is defined by complete abatement of CDI symptoms while on appropriate therapy, followed by reappearance of symptoms within two to eight weeks after treatment has been stopped [2]. Recurrent CDI occurs in 10 to 25 percent of patients treated with antimicrobial therapy.

Data on additional circumstances in which FMT may be beneficial, such as severe and fulminant CDI, are limited and are discussed elsewhere. (See "Clostridioides difficile infection in adults: Treatment and prevention".)

Issues related to FMT are reviewed here. Other issues related to CDI are discussed separately. (See "Clostridioides difficile infection in adults: Epidemiology, microbiology, and pathophysiology" and "Clostridioides difficile infection in adults: Clinical manifestations and diagnosis" and "Clostridioides difficile infection in adults: Treatment and prevention".) (Related Pathway(s): Clostridioides difficile infection: Treatment of adults with an initial or recurrent infection.)

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