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Background. Fecal transplant (FT) is a promising non-antibiotic treatment option for refractory/recurrent Clostridium difficile infection (CDI) and is gaining increasing acceptance. However, the optimal protocol for FT is yet to be determined. We report on enema administration of RBX2660 (microbiota suspension), a next generation fecal transplant, for the treatment of recurrent CDI, with or without antibiotic pre-treatment in the context of the PUNCH CD phase 2 safety study.

Methods. RBX2660 was administered via enema to patients with recurrent CDI within 24-48 hours after completion of a 7-day course of oral vancomycin to bring their CDI under control. No pre-enema bowel prep was required. A second RBX2660 enema treatment was permitted if CDI recurred in< 8 weeks. Antibiotics for CDI were not prescribed prior to the second treatment, and RBX2660 was administered to patients with active CDI. Enema …