Faecal Bacteriotherapy for Postantibiotic Diarrhoea in Critically Ill Patients

NCT ID: NCT05430269

Last Updated: 2023-02-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

36 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-02-09

Study Completion Date

2025-07-01

Brief Summary

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Rationale: Postantibiotic diarrhoea in critically ill patients is common, often prolonged and currently there is no effective treatment of it.

Aim: To test safety and feasibility of faecal microbial transplantation in critically ill patients with postantibiotic diarhoea.

Design: Prospective, single center, parallel group randomised controlled trial. Subjects: ICU patients (both general and burn ICU) who developed diarhea after a course of antibiotic therapy that is persistent for 24 hours and is not due to other causes. Patients with septic shock or approaching death will be excluded.

Treatment in the intervention group: Faecal bacteriotherapy (FBT) delivered as enema (and repeated once in the subgroup of patients with C. dif. infection) of 350 ml of standardised mixed transplantate prepared from faeces of 7 healthy donors.

Control group: Standard-of-care protocolised treatment of postantibiotic diarhea (which includes vancomycine 250 mg p.o. 6 hourly in the subgroup with C. dif. infection).

Primary outcome: Percentage of patients with treatment failure at day 7 after randomisation, which is defined as treatment either not being delivered or not being effective.

Secondary and exploratory outcomes: Influence of the intervention on colonic microbiome and metabolome, small bowel and colonic permeability, bacterial translocation and systemic inflammation response to procedure.

Detailed Description

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Conditions

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Diarrhea Caused by Drug Clostridium Difficile Infections

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Prospective, single center, parallel group randomised controlled trial.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Intervention group

ICU patients who developed diarhea after a course of antibiotic therapy treated with Faecal bacteriotherapy (FBT) delivered as enema

Group Type EXPERIMENTAL

Faecal bacteriotherapy (FBT)

Intervention Type OTHER

Enema of 350 ml of standardised mixed transplantate prepared from faeces of 7 healthy donors.

Control group

ICU patients who developed diarhea after a course of antibiotic therapy treated standard-of-care protocolised treatment of postantibiotic diarhea

Group Type ACTIVE_COMPARATOR

standard-of-care protocolised treatment of postantibiotic diarhea

Intervention Type OTHER

standard-of-care protocolised treatment of postantibiotic diarhea

Interventions

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Faecal bacteriotherapy (FBT)

Enema of 350 ml of standardised mixed transplantate prepared from faeces of 7 healthy donors.

Intervention Type OTHER

standard-of-care protocolised treatment of postantibiotic diarhea

standard-of-care protocolised treatment of postantibiotic diarhea

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* signing of informed consent (see below)
* age \> 18 yrs.
* in-patient in ICU or HDU (incl. burn unit) and expected to stay for \>7 days
* diarrhea following antibiotic treatment defined as 3 or more stools per day or Bristol type 7 stool in the volume \>300 ml/day if stool derivative device is in place, persisting for 24 hours despite enteral feeding formula has been stopped.

Exclusion Criteria

* death appears imminent or ceilings of care put in place
* presence of new-onset sepsis defined as per 2016 definition
* lactate \>2.0 mM, colon diameter \> 9 cm on plain AXR
* the necessity of ongoing antibiotic treatment for another reasons
* unable to tolerate enema for any reason (e.g. surgery of the GI tract in the past year)
* pregnant and lactating woman
* patients with a history of severe anaphylactic food allergy, any other reason which - as per judgement of the treating clinician - makes faecal transplantation unsafe or not feasible (Note: All screening failures based on this criterion will be reported separately, inc. the reason why it was considered unsafe or not feasible to proceed).
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Faculty Hospital Kralovske Vinohrady

OTHER_GOV

Sponsor Role collaborator

Donatio Intensivistam Endowment Fund

UNKNOWN

Sponsor Role collaborator

Charles University, Czech Republic

OTHER

Sponsor Role lead

Responsible Party

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Frantisek Duska, MD, PhD

František Duška, MD, PhD, A/Prof, AFICM, EDIC

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Kralovske Vinohrady University Hospital

Prague, , Czechia

Site Status RECRUITING

František Duška

Prague, Česká Republika, Czechia

Site Status RECRUITING

Countries

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Czechia

Facility Contacts

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Frantisek Duska

Role: primary

+420267162451

František Duška

Role: primary

608405541

References

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Cibulkova I, Rehorova V, Soukupova H, Waldauf P, Cahova M, Manak J, Matejovic M, Duska F. Allogenic faecal microbiota transplantation for antibiotic-associated diarrhoea in critically ill patients (FEBATRICE)-Study protocol for a multi-centre randomised controlled trial (phase II). PLoS One. 2024 Dec 27;19(12):e0310180. doi: 10.1371/journal.pone.0310180. eCollection 2024.

Reference Type DERIVED
PMID: 39729440 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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2021-002290-25

Identifier Type: -

Identifier Source: org_study_id

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