First-Line Therapy for C. difficile Colitis: Does Fecal Microbiota Transplantation Have a Role?

In a randomized trial in Norway, FMT was noninferior to vancomycin.

IDSA guidelines recommend fecal microbiota transplantation (FMT) for patients with multiple recurrences of Clostridioides difficile infection (CDI), but not for the initial episode. Two FMT products (VOWST and Rebyota) are FDA-approved exclusively for prevention of recurrent CDI. To assess the efficacy of FMT as primary treatment (without any preceding antimicrobial treatment), researchers in Norway randomized 100 patients with CDI (first episode within the past year; 33% had severe CDI) to stool-bank FMT delivered by enema versus a standard course of vancomycin.

At day 14 posttreatment in the FMT group, clinical cure was achieved in 71% and recurrences within 60 days occurred in 6%. In the vancomycin group, clinical cure occurred in 78%, wi…

Reviewing Author

Daniel Kaul, MD

Disclosures

Grant/Research SupportNobelpharma; Pfizer

Leadership Positions in Professional SocietiesAmerican Society of Transplantation (Program Committee)

Daniel Kaul, MD

Disclosures

Grant/Research SupportNobelpharma; Pfizer

Leadership Positions in Professional SocietiesAmerican Society of Transplantation (Program Committee)

First-Line Therapy for C. difficile Colitis: Does Fecal Microbiota Transplantation Have a Role?

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Reviewing Author