Hundreds of people with recurrent bacterial infections could be treated with gut bacteria taken from healthy donors. NICE has recommended a faecal microbiota transplant (FMT) is offered to people who have been treated for two or more Clostridium difficile (C. diff) infections without success.
FMT treatment aims to restore a healthy population of gut bacteria and involves transferring gut bacteria and other microorganisms from healthy donor poo into the gut of the recipient.
Clinical trial evidence showed that FMT treatment is significantly better than antibiotics alone at resolving a C. diff infection in people who have had two or more previous infections.
Evidence presented to the NICE Medical Technology Advisory Committee shows the treatment could save the NHS hundreds – or in some cases thousands – of pounds, lead to fewer antibiotics being used, and give patients a better quality of life.
The intestinal bacteria can be delivered through a tube inserted directly into the stomach through the nose, or alternatively be deposited directly into the colon through a tube or swallowed via a pill.
The treatment should be manufactured in accordance with Medicines and Healthcare products Regulatory Agency guidance for human medicines regulation and a strict donor screening programme should be in place to establish risk factors for transmissible diseases and factors influencing the gut microbiota.
Clinical evidence from five randomised controlled trials of 274 adults showed that more C. diff infections were resolved with FMT than antibiotic treatment in four of the trials and there was no difference in the other. FMT can lead to different levels of clinical cure depending on how the treatment is given but it could resolve up to 94% of infections.
Modelling shows that FMT treatment is cheaper than treatment with almost all antibiotics. It saves £769 compared with vancomycin taper pulse (VTP) if FMT is given using colonoscopy and saves £8,297 compared with vancomycin if it’s given using an oral capsule.