P328 Faecal microbiota transplantation as treatment for recurrent
Clostridiodes difficile infection in patients with inflammatory bowel disease: Experiences of the Netherlands donor faeces bank
E. Van Lingen1, A.E. van der Meulen-de Jong1, K.E.W. Vendrik2, E.J. Kuijper2, E.M. Terveer2, J.J. Keller3
1Department of Gastroenterology and Hepatology, LUMC, Leiden, The Netherlands, 2Department of Medical Microbiology, LUMC, Leiden, The Netherlands, 3Department of Gastroenterology, Haaglanden Medical Center, The Hague, The Netherlands
In recent years Faecal Microbiota Transplantation (FMT) is effectively implemented as an approved treatment approach of refractory
The NDFB was founded to facilitate FMT by providing ready to use donor faeces suspensions for treatment of patients with rCDI in hospitals throughout The Netherlands. A request for FMT is evaluated by the working group (specialists in the fields of Medical Microbiology, Gastroenterology, and Infectious Diseases) to assess the indication of FMT and to formulate a treatment advice for each individual patient taking the comorbidity into account. Prior to FMT, all patients were pre-treated with vancomycin 250 mg for at least 4 days and bowel lavage. In patients with ulcerative colitis as comorbidity, prednisone was added when there was an IBD flare simultaneous. The results of FMT were monitored by prospective collection of outcome data by the NDFB.
Since the start of NDFB in March 2016 until August 2019, 186 FMT requests to treat 176 (r)CDI patients were reviewed within the NDFB working group including 26 patients with rCDI and IBD. In total, 129 patients (of which 14 suffered from IBD) were treated with 143 FMTs for CDI with a cure rate of 89.9% after a single FMT (116/129). FMT was deemed not suitable in 12 of 26 patients with IBD because patients had
In IBD patients with rCDI, FMT is equally effective compared with other patients with rCDI. In case of concurrent activity of IBD, pre-treatment with prednisolone in combination with vancomycin appears to be effective.