Abstract
Background: Recipients of faecal microbiota transplantation (FMT) in treatment of recurrent Clostridium difficile infection (RCDI) remain at markedly increased risk of re-infection with C. difficile with new antibiotic provocations. Urinary tract infections (UTIs) are common indications for antibiotics in these patients, often resulting in C. difficile re-infection. Methods: We present a case series of 19 patients treated with parenteral aminoglycosides for UTI following FMT for RCDI. A 3 day outpatient regimen of once-daily intramuscular administration of gentamicin was used to treat 18 consecutive FMT recipients with uncomplicated UTI. One other patient was treated for a complicated UTI with intravenous amikacin. Profiling of 16S rRNA genes was used to track changes in faecal microbial community structure during this regimen in three patients. Results: The protocol was highly effective in treating UTI symptoms. None of the patients suffered a re-infection with C. difficile. The faecal microbial communities remained undisturbed by treatment with intramuscular administration of gentamicin. Conclusions: Despite falling out of favour in recent years, aminoglycoside antibiotics given parenterally have the advantage of minimal penetration into the gut lumen. A brief (3 day) course of parenteral gentamicin was safe and effective in curing UTI in patients at high risk of C. difficile infection without perturbing their gut microbiota.
Original language | English (US) |
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Pages (from-to) | 522-528 |
Number of pages | 7 |
Journal | Journal of Antimicrobial Chemotherapy |
Volume | 72 |
Issue number | 2 |
DOIs | |
State | Published - Feb 2017 |
Bibliographical note
Funding Information:This research was made possible by support of grants from the National Institutes of Health (NIH) 1R21-AI114722-01 (A. K., M. J. S.) and the Minnesota's Discovery, Research, and InnoVation Economy grant from the University ofMinnesota (A. K., M. J. S.).
Publisher Copyright:
© The Author 2016.