Clinical and Economic Evaluation of commercialized Fecal Microbiota Transplant (cFMT) for patients with recurrent Clostridium Difficile infection (CDI) in a large Community Hospital
Background: Recurrent CDI is common despite antibiotic therapy. FMT is effective to reduce recurrent infections. We report our experience with Commercialized FMT (cFMT) products by providing ready-to-use capsules, for oral administration, or solution, for administration via colonoscopy.
Methods: The study was approved by IRB for adult patients with at least 3 episode of recurrent CDI despite antibiotic therapy, patients with severe infection were excluded. cFMT was administered in the hospital or at outpatient center. Each patient was evaluated 8 weeks post-transplant to assess for sustained clinical cure and side effects. The economic impact of cFMT was evaluated using historical data from EHR including: CDI rate, CDI readmission rate, rate of CDI-associated death, cost of CDI admissions, and rate of use of each antimicrobial regimen
Results: 33 patients enrolled (solution/colonoscopy 20 and capsule 13). Mean age was 74 vs 67 y, female 56% vs 64%, recurrent episode 4 vs 3.1, CDI severity score 1.4 vs 1.2. 95% (19/20) of patients who received cFMT via colonoscopy experienced sustained clinical cure vs 85% (11/13) of patients who received capsule. One patient experienced an adverse event from capsule with nausea and vomiting, which resolved without sequelae. 2 of the 3 patients that experienced treatment failure received cFMT from the same donor Due to recurrent episodes. The cost of cFMT was $635 for capsules and $485 for solution which was far less than recurrent CDI associated cost.
Conclusion: cFMT is a viable alternative to traditional FMT and was both clinically and economically beneficial in patients with recurrent CDI in a community hospital. Further studies needed to confirm above findings.
B. Boyett, None