Fecal Microbiota Transplantation for C Diff Infection

  • STATUS
    Recruiting
  • End date
    Dec 26, 2023
  • participants needed
    100
  • sponsor
    Englewood Hospital and Medical Center
Updated on 26 August 2021
antibiotic therapy
antibiotics
vancomycin
microbiota
malignancy
rifaximin
fecal microbiota transplantation
clostridium difficile
nitazoxanide
fidaxomicin
clostridium difficile toxin
toxic megacolon

Summary

The objective of this study is to provide treatment with Fecal Microbiota Transplantation (FMT) to patients with recurrent or refractory Clostridium difficile infection (CDI). It has been shown that good bacteria (like that found in the stool from a healthy donor) attack Clostridium difficile in multiple ways: they make substances that kill Clostridium difficile

  • and they attach to the surface of the colon lining, which prevents the Clostridium difficile toxin (poison) from attaching.

FMT involves infusing a mixture of saline and stool from a healthy donor into the bowel of the patient with CDI during a colonoscopy.

The method used to deliver the FMT will depend on individual characteristics of the subject and is at the discretion of the treating physician. FMT may be administered by the following methods.

  • Colonoscopy: This method allows full endoscopic examination of the colon and exclusion of comorbid conditions (such as IBD, malignancy or microscopic colitis) which may have an impact on subject's treatment or response to therapy.
  • Sigmoidoscopy: This method still allows infusion of the stool into a more proximal segment of the colon than an enema, but may not require sedation. This method may be beneficial in subjects who are elderly or multiparous and who may have difficulty retaining the material when given as enema. Sigmoidoscopic administration eliminates the additional risks associated with colonoscopy in subjects who may not have a clear indication for colonoscopy.
  • Retention enema: This method may be preferable in younger subjects who have already had recent endoscopic evaluation, in subjects who prefer not to undergo endoscopy or in subjects with significant co morbidities and may not tolerate endoscopy.

The physician will administer 300-500 mL of the fecal suspension in aliquots of 60 mL, through the colonoscope or sigmoidoscope or 150 mL via retention enema. In cases of colonoscopic delivery, the material will be delivered to the most proximal point of insertion.

The subject is encouraged to retain stool for as long as possible.

Details
Condition Clostridium Difficile Infection
Treatment Human fecal matter
Clinical Study IdentifierNCT01905709
SponsorEnglewood Hospital and Medical Center
Last Modified on26 August 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

Subject is at least 18 years old
Subject has recurrent or relapsing CDI defined as
At least three episodes of mild-to-moderate CDI and failure of a 6-8 week taper with vancomycin with or without an alternative antibiotic (e.g., rifaximin, nitazoxanide, fidaxomicin). OR
At least two episodes of severe CDI resulting in hospitalization and associated with significant morbidity. OR
Moderate CDI not responding to standard therapy (vancomycin) for at least a week. OR
Severe C. difficile infection with toxic megacolon, not responding to standard therapy or the use of IVIg
Subject is willing and able to provide informed consent
If a female of childbearing potential, subject has agreed to use an acceptable form of birth control for up to 4 weeks after FMT treatment

Exclusion Criteria

Subject is pregnant
Subject is unable to comply with study requirements
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