What is the washout protocol for Fecal Microbiota Transplantation (FMT) for Clostridioides difficile (C. difficile) infection?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: February 19, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

For Fecal Microbiota Transplantation (FMT) for Clostridioides difficile (C. difficile) infection, a commonly recommended washout protocol involves stopping antibiotics at least 24 hours prior to FMT, if possible [ 1, 1 ].

Key Considerations

  • A minimum washout period of 24 hours between the last dose of antibiotic and treatment with FMT is recommended to minimize any deleterious effect of antimicrobials on the FMT material 1.
  • A bowel preparation, such as polyethylene glycol (PEG) 3350, may be used to prepare the gut for FMT 1.
  • The goal of the washout protocol is to reduce the bacterial load and prepare the gut for the FMT.

Additional Recommendations

  • Consider using prokinetics (such as metoclopramide) prior to FMT via the upper gastrointestinal tract route 1.
  • Follow best practice for prevention of further transmission of C. difficile when administering FMT to patients 1.
  • If upper gastrointestinal tract administration is used, nasogastric, nasoduodenal or nasojejunal tube, upper gastrointestinal endoscopy or a permanent feeding tube may be used for delivery 1.

From the Research

Fecal Microbiota Transplantation (FMT) for Clostridioides difficile (C. difficile) Infection

The provided studies discuss the use of Fecal Microbiota Transplantation (FMT) for the treatment of Clostridioides difficile (C. difficile) infection. However, the specific details of the washout protocol for FMT are not explicitly mentioned in the studies.

Available Information on FMT

  • FMT has been shown to be effective in treating recurrent C. difficile infection (CDI) 2, 3, 4, 5, 6.
  • The treatment involves the use of a stool sample collected from a healthy, screened donor to restore healthy microbiota in the colon of a patient with CDI 2.
  • FMT can be administered via different routes, including nasogastric tube 5 and colonoscopy 3.
  • The efficacy and safety of FMT for CDI in patients with underlying inflammatory bowel disease (IBD) have been studied, with results showing that FMT is a highly effective therapy for preventing recurrent CDI in these patients 6.

Limitations of Available Information

  • The studies do not provide specific details on the washout protocol for FMT.
  • The information available is focused on the efficacy and safety of FMT for CDI, rather than the specific procedures involved in the treatment.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

A Practical Method for Preparation of Fecal Microbiota Transplantation.

Methods in molecular biology (Clifton, N.J.), 2016

Research

Successful use of early, repeat fecal microbiota transplantation for initial treatment of severe, refractory Clostridioides difficile colitis.

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.