100 Participants Needed

Fecal Transplant for C Diff Infection

MF
RC
SK
Overseen BySandarsh Kancherla, MD
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Englewood Hospital and Medical Center
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

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.

Will I have to stop taking my current medications?

The trial protocol does not specify whether you need to stop taking your current medications. However, since the trial involves treating recurrent or severe C. difficile infections, it's possible that you may need to continue certain antibiotics as part of your treatment plan.

Is fecal microbiota transplantation (FMT) safe for treating C. difficile infections?

FMT is generally considered safe and well-tolerated, even in high-risk patients, with most short-term risks being mild and related to delivery methods. Long-term side effects are not well established, but no serious harm has been found to date. Careful donor screening is important to minimize risks, and ongoing research aims to improve safety and tolerability.12345

How is fecal transplant treatment different from other treatments for C. diff infection?

Fecal transplant treatment is unique because it uses stool from a healthy donor to restore the natural balance of bacteria in the patient's gut, unlike traditional treatments that rely on antibiotics to kill the bacteria. This approach is particularly effective for patients with recurrent infections where antibiotics have failed.678910

What data supports the effectiveness of the treatment for C. difficile infection?

Fecal microbiota transplantation (FMT) is shown to be highly effective in treating recurrent C. difficile infections, with cure rates over 90% reported from multiple centers. It works by restoring healthy bacteria in the gut, which helps resolve symptoms.69111213

Who Is on the Research Team?

MF

Marc Fiorillo, MD

Principal Investigator

Englewood Hospital and Medical Center

Are You a Good Fit for This Trial?

This trial is for adults who've had multiple severe Clostridium difficile infections (CDI) that led to hospital stays or didn't respond to standard treatments like vancomycin. Participants must be able to give informed consent and, if they can have children, agree to use birth control for up to 4 weeks after treatment. Pregnant individuals or those unable to follow the study plan cannot join.

Inclusion Criteria

At least two episodes of severe CDI resulting in hospitalization and associated with significant morbidity
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)
See 7 more

Exclusion Criteria

Subject is pregnant
Subject is unable to comply with study requirements

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive Fecal Microbiota Transplantation (FMT) via colonoscopy, sigmoidoscopy, or retention enema

1 day
1 visit (in-person)

Follow-up

Participants are monitored for CDI recurrence and safety for 8 weeks post FMT

8 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • Human fecal matter
Trial Overview The trial tests Fecal Microbiota Transplantation (FMT), where stool from a healthy donor mixed with saline is infused into the patient's bowel via colonoscopy, sigmoidoscopy, or enema. The method depends on individual needs and physician discretion. The goal is for good bacteria in the transplant to fight off CDI by killing C. difficile and blocking its toxins.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: All patientsExperimental Treatment1 Intervention
150-500 ml of human fecal matter

Find a Clinic Near You

Who Is Running the Clinical Trial?

Englewood Hospital and Medical Center

Lead Sponsor

Trials
21
Recruited
770+

Published Research Related to This Trial

Fecal microbiota transplantation (FMT) is an effective treatment for recurrent Clostridium difficile infections, helping to restore healthy gut bacteria and resolve symptoms.
The chapter presents a rapid and cost-effective method for preparing FMT using simple, disposable materials, making the procedure more accessible for patients.
A Practical Method for Preparation of Fecal Microbiota Transplantation.Perez, E., Lee, CH., Petrof, EO.[2020]
Fecal microbiota transplantation (FMT) is recommended for treating recurrent Clostridium difficile infections and has shown benefits for various gastrointestinal disorders, but safety data is still limited due to the rapid adoption of the technique without extensive long-term studies.
Capsulized FMT therapy offers a promising solution for long-term maintenance and reduces the need for invasive procedures, indicating a shift towards safer and more tolerable methods of delivering FMT.
[Current research progress and thinking of fecal microbiota transplantation for the treatment of gastrointestinal disorders].Li, N., Tian, H.[2020]
Fecal microbiota transplantation (FMT) is a generally safe and well-tolerated procedure for treating recurrent Clostridioides difficile infections, even in high-risk patients, with most short-term risks being mild and related to delivery methods.
Recent concerns have emerged regarding serious adverse events linked to FMT products from stool banks that do not screen for multi-drug resistant organisms, highlighting the need for improved safety protocols.
Fecal Microbiota Transplantation: Is It Safe?Park, SY., Seo, GS.[2021]

Citations

Oral Vancomycin Followed by Fecal Transplantation Versus Tapering Oral Vancomycin Treatment for Recurrent Clostridium difficile Infection: An Open-Label, Randomized Controlled Trial. [2022]
A case of toxic megacolon caused by clostridium difficile infection and treated with fecal microbiota transplantation. [2020]
A Practical Method for Preparation of Fecal Microbiota Transplantation. [2020]
Randomized clinical trial to evaluate the effect of fecal microbiota transplant for initial Clostridium difficile infection in intestinal microbiome. [2022]
Fecal microbiota transplantation in relapsing Clostridium difficile infection. [2022]
[Current research progress and thinking of fecal microbiota transplantation for the treatment of gastrointestinal disorders]. [2020]
Fecal Microbiota Transplantation: Is It Safe? [2021]
Fecal microbiota transplantation for recurrent C. difficile infection in patients with inflammatory bowel disease: experience of a large-volume European FMT center. [2022]
Fecal microbiota transplantation via colonoscopy for recurrent C. difficile Infection. [2022]
Fecal microbiota transplantation for recurrent Clostridium difficile infection in hematopoietic stem cell transplant recipients. [2021]
11.United Statespubmed.ncbi.nlm.nih.gov
Stool therapy may become a preferred treatment of recurrent Clostridium difficile? [2021]
Fecal microbiota transplantation in recurrent Clostridium difficile infection: A retrospective single-center chart review. [2022]
[Fecal microbiota transplantation, a novel therapy for recurrent Clostridium difficile infection]. [2020]
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