Fecal microbial transplant per non-inferior oral capsule for CDI


(HealthDay) -For patients with recurrent infection of Clostridium difficile (RCDI), fecal microbial transplantation (FMT) with oral capsules is not lower than FMT by colonoscopy, according to a study published in the November 28 issue of Journal of the American Medical Association .

Dina Kao, M.D., of the University of Alberta in Edmonton, Canada, and colleagues conducted a non-inferiority, non-blinded study involving 116 adult patients with RCDI in three academic centers. The participants were randomized to FMT per capsule or colonoscopy in a ratio of 1 to 1 (57 and 59 patients, respectively).

Researchers found that prevention of RCDI after a single treatment was achieved in 96.2 percent of participants in the capsule and colonoscopy groups in the per-protocol badysis (difference, 0 percent), which met the criteria of non-inferiority. In each group, one patient died of cardiopulmonary disease, which was not related to FMT. The rates of minor adverse events were 5.4 and 12.5 percent for the capsule and colonoscopy groups, respectively. The improvement in quality of life did not differ significantly between the groups. The proportion of patients who rated their experience as unpleasant was significantly higher for those who received capsules (66 versus 44 percent).

"When FMT is administered in oral capsules, it can be administered in clinics, which could reduce the cost and waiting time, and complete economic evaluations are needed to understand the value and effectiveness of FMT through the oral capsule." , the authors write.

Several authors revealed financial links with the pharmaceutical industry.

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