An Intragastric Fecal Microbiota Transplantation Program for Treatment of Recurrent Clostridium difficile in Children is Efficacious, Safe, and Inexpensive - 23/02/18
, Edwin F. De Zoeten, MD, PhD 1, 2, Amy Pyo-Twist, RN 3, Sara Fidanza, RN 3, Shannon Hughes, PA 4, Susan A. Dolan, RN, MS 5, Jason Child, PharmD 6, Samuel R. Dominguez, MD, PhD 4, 5Abstract |
Objective |
To assess the safety, efficacy, and relative expense of a nurse-led fecal microbiota transplantation (FMT) program for the treatment of recurrent Clostridium difficile infection (CDI).
Study design |
Retrospective cohort study design in children aged 1-18 years with recurrent CDI. The intervention was an intragastric FMT with stool derived from a donor stool bank. Primary outcome was resolution of diarrhea at 3 months post-transplantation. A secondary analysis compared charge data associated with FMT by intragastric delivery vs administration by colonoscopy or nasoduodenal tube.
Results |
A total of 47 intragastric FMT procedures were performed in 42 children (median age 9 years) with recurrent CDI. Response to treatment varied by disease status, with 94% success in previously healthy children, 75% in medically complex children, and 54% in children with inflammatory bowel disease (P = .04). FMT via intragastric delivery showed lower facility and professional charges by 85% and 78% compared with delivery via colonoscopy and radiology-placed nasoduodenal tube, respectively. The use of stool derived from a donor stool bank decreased charges by 49% compared with charges associated with the use of a donor who was a relative.
Conclusion |
A nurse-led intragastric FMT procedure using stool derived from a donor stool bank is a relatively inexpensive and efficacious treatment for recurrent CDI in children. Intragastric FMT success in children was attenuated by the presence of underlying disease, particularly inflammatory bowel disease.
Le texte complet de cet article est disponible en PDF.Abbreviations : CDI, FMT, GI, IBD, NGT, RN
Plan
| The authors declare no conflicts of interest. |
Vol 194
P. 123 - mars 2018 Retour au numéro
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