Faecal microbiota transplantation for recurrent Clostridioides difficile infection: experience with lyophilized oral capsules.
BACKGROUND
Faecal microbiota transplantation (FMT) is a highly effective approach for refractory and recurrent Clostridioides difficile infection (CDI). Despite its excellent efficacy, FMT is not yet a routine procedure in most centres. There is very little experience with FMT based on lyophilized capsules, and data from European institutions are lacking. This article describes our experience with FMT to treat recurrent CDI using lyophilized oral capsules.


METHODS
A prospectively recorded single-centre case series of patients with recurrent CDI who underwent FMT between January 2018 and May 2019 were analysed. The primary outcome was defined as resolution of CDI without recurrences over a two-month period. Overall resolution was defined as resolution of diarrhoea without recurrence of CDI within two months after a further cycle of FMT. The FMT process involved oral ingestion of four or five lyophilized capsules in a single dose. All stool donors were rigorously screened.


FINDINGS
FMT was performed in 32 patients. Primary cure was achieved in 81.3% of patients, and the overall cure rate was 87.5%. FMT via lyophilized capsules was well tolerated. No FMT procedure-related adverse events and no further complications were observed for lyophilized-capsule FMT.


CONCLUSIONS
This initial clinical experience suggests that FMT based on oral lyophilized preparations is a safe, well-tolerated, and highly effective treatment for recurrent CDI. Administration of oral lyophilized capsules seems feasible in hospital routine and will enable FMT to be more widely used.
['Reigadas|E|E|', 'Bouza|E|E|', 'Olmedo|M|M|', 'Vázquez-Cuesta|S|S|', 'Villar-Gómara|L|L|', 'Alcalá|L|L|', 'Marín|M|M|', 'Rodríguez-Fernández|S|S|', 'Valerio|M|M|', 'Muñoz|P|P|']
D000284:Administration, Oral D000368:Aged D000369:Aged, 80 and over D002214:Capsules D003015:Clostridium Infections D000069467:Fecal Microbiota Transplantation D005243:Feces D005260:Female D005612:Freeze Drying D006784:Hospitals, Teaching D006801:Humans D008297:Male D008875:Middle Aged D011446:Prospective Studies D012008:Recurrence D016896:Treatment Outcome
Faecal microbiota transplantation Lyophilized capsules Bacteriotherapy C. difficile Freeze-dried Gut microbiota