Exploring the variation across countries in access to faecal microbiota transplantation

Doctors examining gastrointestinal tract, illustration by Iuliia/Adobe Stock

What is the issue?

In recent years, there has been a growing interest in the use of Faecal Microbiota Transplantation (FMT) to treat recurrent C. difficile infection. C. difficile is a bacteria that is commonly found in the human digestive system. In healthy people, the bacteria does not cause any harm as it is kept from multiplying to harmful levels by other gut bacteria. However, the use of antibiotics can kill the gut bacteria that keeps C. difficile supressed, causing it to multiply to toxic levels.

FMT involves transferring a mixture of liquid stool from a donor into the intestines of the patient. Numerous ongoing studies suggest FMT to be safe and effective. However, there are a number of challenges associated with the implementation and administration of FMT. Some examples include finding and screening donors, keeping samples usable and maintaining stool banks, ensuring access to services and the capacity of the workforce to deliver FMT and standardising practices. Thus, there is a need for further research in this field, to understand how to support good practice in the care of patients with recurrent C. difficile infection.

How are we helping?

RAND Europe has been commissioned by Ferring Pharmaceuticals to undertake an independent study that will explore:

  • Current practice and differences in the establishment, running and distribution of stool banks and in the availability of FMT to patients with recurrent C. difficile infection, across a sample of geographies.
  • Key themes related to standardisation and regulation of FMT practice.
  • Potential challenges related to FMT and areas in need of improvement for patient care.

The main focus is on learning from a range of countries including, but not confined to UK, Italy, France, Australia and Canada.

The project will include:

  1. A rapid evidence assessment to synthesise the knowledge base on the availability of FMT for patients with recurring C. difficile infection.
  2. Key informant interviews with clinical and non-clinical experts (e.g. microbiologists) to further explore the themes arising from the rapid evidence assessment and identify gaps in the literature.
  3. A consultative workshop with an expert panel.