Fecal transplants to be offered to hundreds with antibiotic-resistant superbug | UK News
Hundreds of people with a difficult-to-treat superbug are to be offered stool transplants to help fight their infections.
In a fecal microbiota transplant (FMT), healthy bacteria are introduced into another person’s gut “in a mixture of prepared, processed stool from a healthy donor.”
The National Institute for Health and Care Excellence (Nice) says the procedure 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 from a healthy person’s feces can help restore healthy gut bacteria, Nice said.
C.diff is a type of bacteria that can cause diarrhea and commonly affects people who have taken antibiotics.
The bug can usually be treated with another type of antibiotic, but is sometimes called a “superbug” because in some cases it is resistant to the treatment.
According to Nice, clinical trials have shown that FMT treatment is significantly better than antibiotics alone at solving a stubborn C.diff infection, and treatment with this method could save the NHS thousands of pounds.
Patients may need to take fewer antibiotics and have reported a better quality of life after treatment, she added.
The FMT portion can be swallowed in a pill or administered through a tube inserted directly into the stomach through the nose, or alternatively delivered through a tube directly into the colon.
Mark Chapman, Nice’s interim director of medical technology, said: “There is a current need for an effective treatment for C.diff in people who have received two or more rounds of antibiotics.
“Our committee’s recommendation of this innovative treatment will provide healthcare professionals with another tool to use in the fight against this infection, while balancing the need to provide the best care at value for money .
“The use of this treatment will also help reduce antibiotic dependency and thereby reduce the likelihood of antibiotic resistance, supporting NICE guidelines for good antimicrobial stewardship.”
Nice said it made its decision to move forward with FMT after reviewing the evidence from five studies involving 274 adults that showed four of the studies treated more C.diff infections with FMT than antibiotics — and there were no difference in the miscellaneous.
The data also showed that the treatment can clear up to 94% of infections.
FMT can be significantly cheaper than antibiotics when administered as an oral capsule – saving over £8,000; It can save hundreds of pounds when given as a colonoscopy, but is more expensive when given as an enema.
Nice estimates that 450 to 500 people in England could be treated with FMT for multiple recurrences of C.diff infections each year.
A rigorous donor screening program should be in place and treatments should be manufactured in accordance with human medical practice.
All donors are screened in advance to ensure the stool provided is healthy and tested for a wide range of viral, bacterial and parasitic infections, which includes screening COVID-19.