Patients with recurrent Clostridium difficile (C. diff) should be offered a faecal microbiota transplant (FMT), NICE has recommended.
NICE has suggested the treatment for patients who have been treated for two or more C. diff infections without results, with experts estimating 450 to 500 people could be treated using FMT annually.
FMT treatment uses gut bacteria taken from a healthy donor’s faeces to restore a healthy population of gut bacteria in the patient.
Clinical trial evidence demonstrated FMT treatment is ‘significantly better than antibiotics alone’ at clearing a C. diff infection in those who have had two or more infections.
Evidence from five randomised controlled trials of 274 adults found that more C. diff infections were solved with FMT than antibiotic treatment in four of the trials and there was no difference in the other.
FMT’s effectiveness depends on how the treatment is given but it could resolve up to 94% of infections, NICE said.
The intestinal bacteria can be given through a tube inserted straight into the stomach through the nose, or it can be deposited directly into the colon through a tube or swallowed via a pill.
C. diff is a bacterium which causes an infection if the bowel’s bacteria balance changes, leading to diarrhoea. Older people are at higher risk and the infection is highly transmissible.
It is most common in people who have recently or are currently taking antibiotics, and can range from mild to life-threatening, and is treated with antibiotics in the first instance.
NICE interim director of medical technology Mark Chapman 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.’
