Introduction:
During the COVID-19 pandemic, a marked increase in the incidence of Clostridioides difficile infection (CDI) was observed in Poland. This trend has been associated with widespread antibiotic use and healthcare burden during the SARS-CoV-2 pandemic. High disease severity, frequent recurrences, and limited therapeutic options continue to make CDI a significant clinical challenge.

Aim:
To describe the clinical course and outcomes of fecal microbiota transplantation (FMT) in patients with Clostridioides difficile infection following COVID-19.

Material and methods:
This retrospective case series included four adult patients who developed CDI shortly after COVID-19. All patients underwent FMT between April and August 2021. Three patients experienced at least two severe recurrences before FMT, whereas one patient with fulminant CDI underwent FMT after the first episode. Clinical outcomes were assessed based on symptom resolution and absence of recurrence during follow-up.

Results and Discussion:
All patients experienced resolution of diarrhea and gastrointestinal symptoms following FMT. No CDI recurrences were observed during follow-up. No procedure-related complications were reported. Although limited by the small sample size, heterogeneous study population, and retrospective design, the findings suggest that FMT may be a feasible therapeutic option in selected patients with severe or recurrent CDI following COVID-19.

Conclusions:
In this small retrospective case series, fecal microbiota transplantation was associated with favorable clinical outcomes and absence of CDI recurrence during follow-up in patients with severe or recurrent CDI following COVID-19.