FMT safe, effective for C. difficile infection in pediatric patients
While fecal microbiota transplantation has long been established as a treatment for adult patients with Clostridioides difficile infection, data from a study revealed that it is also safe and effective in pediatric patients.
Stacy A. Kahn, MD, of Boston Children's Hospital, and colleagues wrote in Clinical Gastroenterology and Hepatology that C. diff has become increasingly recognized in younger patients, but concerns about treating it with FMT still remain.
“Alterations in the microbiome have been associated with the development of autoimmune, metabolic, and psychiatric diseases,” they wrote. “The implications of altering the microbiome at such an early age in development make these safety concerns particularly relevant to pediatric patients and warrant further investigation.”
Researchers performed a retrospective study comprising 335 patients aged between 11 months and 23 years who underwent FMT between 2004 and 2019 and had at least 2 months of outcome data. They wanted to assess the success of FMT — defined as no CDI recurrence within 2 months of FMT — and indent factors associated with successful FMT.
After a single FMT, 81% of patients were able to avoid recurrence (271/335). In the 64 patients who did experience recurrence, treatment was successful in 19 of the 34 who underwent repeat FMT, giving FMT an overall success rate of 86.6%.
Researchers determined that patients who received FMT with fresh donor stool (OR = 2.66; 95% CI, 1.39–5.08), via colonoscopy (OR = 2.41; 95% CI, 1.26–4.61), did not have a feeding tube (OR = 2.08; 95% CI, 1.05–4.11) and had one less episode of CDI before FMT (OR = 1.2; 95% CI, 1.04–1.39) all had increased odds for successful FMT.
Kahn and colleagues found that FMT also had a good safety profile as only 19 patients experienced adverse events related to FMT, with diarrhea, pain and bloating as the most common.
“Our study suggests that FMT is effective and safe for children with CDI and represents a therapy that may be worth consideration earlier in their disease course,” Kahn and colleagues wrote. “Future prospective controlled studies of FMT are essential to fully evaluate the efficacy, safety, optimal timing, dose, delivery route, and preparation of FMT in children with CDI.” – by Alex Young
Disclosures: The authors report no relevant financial disclosures.