Methods: Retrospective case-control study of patients who underwent FMT at a tertiary institution from January 2011 through September 2014. Patients were divided between success or failure following FMT. Data pertaining to patient demographics, antibiotic therapy for clostridium difficile infection, index antibiotic, steroid use, other immunosuppressants, proton pump inhibitors, presence of inflammatory bowel disease, relapses, and FMT technique were compared between the groups. Antibiotic therapy included in the study were metronidazole, oral vancomycin, vancomycin taper, fidaxomycin, rifaximin and nitazoxanide
Results: 109 patients were included in the analysis; 10 were cases (patients who relapsed following FMT) and 99 were controls (patients who were successfully treated with FMT). Patients in the case group were treated with metronidazole 9 (90%), vancomycin 9 (90%), fidaxomicin 5 (50%), rifaximin 2 (20%) and vancomycin taper 6 (60%). Treatment in the control group included metronidazole 84 (84.8%), vancomycin 99 (100%), fidaxomicin 27 (27.3%), rifaximin 16 (16.2%) and vancomycin taper 83 (83.8%). Factors including the index antibiotic, use of steroids, other immunosuppressants, proton pump inhibitors, presence of inflammatory bowel disease were analyzed and were not found to be statistically significant. Delivery site of transplanted stool, volume, weight of stool used, and endoscopist performing the procedure also did not affect outcomes. In multivariable analysis, only significant variable was oral vancomycin taper at OR=0.148 [95% CI: 0.029, 0.753]; p=0.021. (table 1). There was an 85% risk reduction in patients who received vancomycin taper compared to those who did not.
|No||4 (40.0%)||16 (16.2%)||20 (18.3%)|
|Yes||6 (60.0%)||83 (83.8%)||89 (81.7%)|
C. Griesbach, None
H. Kosiorek, None
R. Orenstein, Rebiotix Inc.: Investigator and Scientific Advisor , Consulting fee and Research support
R. Patron, None