• Emily N Tixier, Elijah Verheyen, Ryan C Ungaro, and Ari M Grinspan.
• Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, NY, USA.
• Aliment. Pharmacol. Ther. 2019 Nov 1; 50 (10): 1094-1099.

BackgroundSevere and fulminant Clostridioides difficile infection is associated with high mortality rates. While faecal microbiota transplant has been shown to be effective for recurrent C difficile infection, there is little data on the utility of faecal microbiota transplant in severe or fulminant C difficile infection.AimTo compare the outcomes of antibiotics and faecal microbiota transplantation vs antibiotics alone (standard of care) in critically ill patients with severe or fulminant C difficile infection.MethodsThis was a retrospective, matched cohort study in one urban tertiary academic care centre including 48 patients hospitalised with severe or fulminant C difficile infection who required care in intensive care unit.ResultsPatients who received faecal microbiota transplantation (n = 16) had a 77% decrease in odds for mortality (OR 0.23, 95% CI 0.06-0.97) with a number needed to treat of 3 to prevent one death.ConclusionsFaecal microbiota transplantation provides mortality benefit over standard of care for severe and fulminant C difficile infection and should be considered in critically ill patients.© 2019 John Wiley & Sons Ltd.

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