Info

🌱來自: fecal microbiota transplantation

Indications of Fecal Microbiota Transplantation

• limited evidence to define who may benefit most from fecal microbiota transplantation (FMT)
• FMT typically offered to patients with^1,2
  • ≥ 3 episodes of Clostridioides (Clostridium) difficile infection (CDI) proven by positive stool assay and failure of first-line therapies for CDI (including vancomycin, metronidazole, or fidaxomicin)
  • 2 previous episodes of CDI requiring hospitalization
  • severe disease without response to appropriate therapy after 48 hours
  • moderate CDI without response to appropriate therapy (oral vancomycin or fidaxomicin) after 5 days (these patients typically have severe CDI or other cause of diarrhea)
• before FMT, confirm that disease is caused by C. difficile using glutamate dehydrogenase assay, enzyme immunoassays, or nucleic acid amplification tests followed by enzyme immunoassay for toxin A/B (see also [Clostridioides (Clostridium) difficile Infection in Adults][3] or [Clostridioides (Clostridium) difficile Infection in Children][4] for information on diagnostic testing)²
• patients must be able to safely¹
  • undergo colonoscopy or endoscopy
  • stop specific medications, including concomitant antibiotics (24-48 hours prior to FMT administration) and gastric acid suppression medications
• considerations in specific populations²
  • lack of evidence on safety in patients with severe neutropenia (absolute neutrophil count < 500/mcL)
  • FMT reported to be safe in other patients with immunocompromise
  • very little evidence on safety of FMT in pregnant women so consider delaying until after birth

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title:Indications of Fecal Microbiota Transplantation date: “2023-02-02” enableToc: false

Info

🌱來自: fecal microbiota transplantation

Indications of Fecal Microbiota Transplantation

• limited evidence to define who may benefit most from fecal microbiota transplantation (FMT)
• FMT typically offered to patients with^1,2
  • ≥ 3 episodes of Clostridioides (Clostridium) difficile infection (CDI) proven by positive stool assay and failure of first-line therapies for CDI (including vancomycin, metronidazole, or fidaxomicin)
  • 2 previous episodes of CDI requiring hospitalization
  • severe disease without response to appropriate therapy after 48 hours
  • moderate CDI without response to appropriate therapy (oral vancomycin or fidaxomicin) after 5 days (these patients typically have severe CDI or other cause of diarrhea)
• before FMT, confirm that disease is caused by C. difficile using glutamate dehydrogenase assay, enzyme immunoassays, or nucleic acid amplification tests followed by enzyme immunoassay for toxin A/B (see also [Clostridioides (Clostridium) difficile Infection in Adults][3] or [Clostridioides (Clostridium) difficile Infection in Children][4] for information on diagnostic testing)²
• patients must be able to safely¹
  • undergo colonoscopy or endoscopy
  • stop specific medications, including concomitant antibiotics (24-48 hours prior to FMT administration) and gastric acid suppression medications
• considerations in specific populations²
  • lack of evidence on safety in patients with severe neutropenia (absolute neutrophil count < 500/mcL)
  • FMT reported to be safe in other patients with immunocompromise
  • very little evidence on safety of FMT in pregnant women so consider delaying until after birth