Fecal Microbiota Transplantation Capsules with Targeted Colonic Versus Gastric Delivery in Recurrent Clostridium difficile Infection: A Comparative Cohort Analysis of High and Lose Dose
- PMID: 30519847
- DOI: 10.1007/s10620-018-5396-6
Fecal Microbiota Transplantation Capsules with Targeted Colonic Versus Gastric Delivery in Recurrent Clostridium difficile Infection: A Comparative Cohort Analysis of High and Lose Dose
Erratum in
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Correction to: Fecal Microbiota Transplantation Capsules with Targeted Colonic Versus Gastric Delivery in Recurrent Clostridium difficile Infection: A Comparative Cohort Analysis of High and Low Dose.Dig Dis Sci. 2019 Jul;64(7):2059. doi: 10.1007/s10620-019-05527-4. Dig Dis Sci. 2019. PMID: 30778870
Abstract
Background: Fecal microbiota transplantation (FMT) is an effective therapy for recurrent Clostridium. difficile infection (rCDI). FMT capsules have emerged, and it is unknown if delivery location and dose impact efficacy.
Methods: We compared two cohorts of patients receiving two capsule formulations: gastric release (FMTgr) and targeted colonic release (FMTcr) at two different sites. Cohort A received FMTgr at (1) high dose: 60 capsules and low dose: 30 capsules. Patients in Cohort B received FMTcr at (1) high dose: 30 capsules (2) low dose: 10 capsules. Clinical cure rates and adverse events were monitored through week 8. Paired t-tests were used to compare diversity pre- and post-FMT.
Results: 51 rCDI patients were enrolled. Cohort A contained n = 20 and Cohort B contained n = 31. Overall cure at week 8 for FMTgr was 75% (15/20) compared to 80.6% for FMTcr, (25/31), p = 0.63. Both formulations were safe with no serious adverse events. FMTcr was superior at increasing gut microbial diversity.
Discussion: To our knowledge, this is the first study to compare targeted delivery of FMT capsules. While both capsules were safe and efficacious, microbial engraftment patterns were superior in FMTcr.
Keywords: Clostridium difficile infection; Fecal capsule; Fecal microbiota transplantation; Microbiome.
Comment in
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Concise Commentary: Treatment of Recurrent C. difficile Infection: A New Take on the Fecal-Oral Route.Dig Dis Sci. 2019 Jun;64(6):1679. doi: 10.1007/s10620-019-05498-6. Dig Dis Sci. 2019. PMID: 30762209 No abstract available.
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