Fecal Transplant by Capsule as Effective as Colonoscopy for CDI

Every year in the U.S., approximately 500,000 people develop Clostridioides difficile infection (CDI) - which is typically a complication of antibiotics. Antibiotics are also used to treat CDI, which further damage the intestinal microbiota. Now, researchers have found that Fecal Microbiota Transplant (FMT) using capsules containing freeze-dried microbes taken orally has similar safety and effectiveness to colonoscopic administration of liquid FMT for treating recurrent CDI.

The research team at the University of Minnesota Medical School (Minneapolis, MN, USA) has developed standardized FMT preparations - which are composed of intestinal microbes that can restore a healthy intestinal microbiota. This strategy repairs the damage caused by antibiotics and restores resistance against CDI. In a multi-centered, national prospective study, 301 FMTs were performed in 269 patients. Two-thirds of the procedures were capsule FMT. CDI cure rates were 86% at one month and 81% at two months. There was no difference in the one-month or two-month cure rate between capsule and colonoscopic FMT.

While highly effective overall, the research team says patient selection is a key factor to optimizing FMT success. Older age, hemodialysis and post-FMT antibiotics were associated with lower cure rates. Further research is suggested to identify patients that do not have a successful FMT and understand why they don’t respond to the therapy.

“Capsule FMT can avoid complications of colonoscopy and facilitate access to this potentially life-saving therapy,” said Byron Vaughn, MD, MS, associate professor in the Medical School and gastroenterologist at M Health Fairview.

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University of Minnesota Medical School