Hundreds of people with a hard-to-treat superbug are to be offered faecal transplants to tackle their infections.
A faecal microbiota transplant (FMT) involves taking healthy bacteria “in a mixture of prepared processed stool from a healthy donor” to the intestine of another person.
The National Institute for Health and Care Excellence (Nice) says the process should be considered for patients who have had two or more treatments for Clostridium difficile (C.diff) without success.
Treating these people with gut bacteria taken from a healthy person’s poo can help restore healthy gut bacteria, Nice said.
C.diff is a type of bacteria that can cause diarrhoea, and it often affects people who have been taking antibiotics.
The bug can usually be treated with a different type of antibiotic, but it is sometimes referred to as a “superbug” due to its resistance to treatment in some instances.
Nice said clinical trials have shown FMT treatment is significantly better than antibiotics alone at resolving a stubborn C.diff infection, and treatment using this method could save the NHS thousands of pounds.
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Patients may need to take fewer antibiotics and have reported a better quality of life after treatment, it added.
‘Innovative’
The FMT section can be swallowed within a pill, or it can be delivered through a tube inserted directly into the stomach through the nose, or alternatively be deposited directly into the colon, also through a tube.
Mark Chapman, interim director of medical technology at Nice, said: “There is currently a need for an effective treatment of C.diff in people who have had two or more rounds of antibiotics.
“Our committee’s recommendation of this innovative treatment will provide another tool for health professionals to use in the fight against this infection, while at the same time balancing the need to offer the best care with value for money.
“Use of this treatment will also help reduce the reliance on antibiotics and in turn reduce the chances of antimicrobial resistance, which supports NICE’s guidance on good antimicrobial stewardship.”
Study
Nice said it made its decision to push ahead with FMT after reviewing evidence from five trials of 274 adults, which showed more C.diff infections were resolved with FMT, than antibiotic treatment, in four of the trials – and there was no difference in the other.
The data also showed the treatment can resolve up to 94% of infections.
FMT can be considerably cheaper than antibiotics if given as an oral capsule – saving more than £8,000; it can save hundreds of pounds if given as a colonoscopy, but it is more expensive when given as an enema.
Nice has estimated that 450 to 500 people in England could be treated using FMT for multiple recurrences of C.diff infections each year.
It said a strict donor screening programme should be in place and that treatments should be manufactured in accordance with human medicine regulations.
All donors will be been screened in advance to ensure the stool provided is healthy and tested for a wide array of viral, bacterial and parasitic infections, which also includes screening for COVID-19.
