The use of faecal microbiota transplant as treatment for recurrent or refractory Clostridium difficile infection and other potential indications: joint British Society of Gastroenterology (BSG) and Healthcare Infection Society (HIS) guidelines
Benjamin H Mullish, Mohammed Nabil Quraishi, Jonathan P Segal, Victoria L McCune, Melissa Baxter, Gemma L Marsden, David J Moore, Alaric Colville, Neeraj Bhala, Tariq H Iqbal, Christopher Settle, Graziella Kontkowski, Ailsa L Hart, Peter M Hawkey, Simon D Goldenberg, Horace R T Williams, Benjamin H Mullish, Mohammed Nabil Quraishi, Jonathan P Segal, Victoria L McCune, Melissa Baxter, Gemma L Marsden, David J Moore, Alaric Colville, Neeraj Bhala, Tariq H Iqbal, Christopher Settle, Graziella Kontkowski, Ailsa L Hart, Peter M Hawkey, Simon D Goldenberg, Horace R T Williams
Abstract
Interest in the therapeutic potential of faecal microbiota transplant (FMT) has been increasing globally in recent years, particularly as a result of randomised studies in which it has been used as an intervention. The main focus of these studies has been the treatment of recurrent or refractory Clostridium difficile infection (CDI), but there is also an emerging evidence base regarding potential applications in non-CDI settings. The key clinical stakeholders for the provision and governance of FMT services in the UK have tended to be in two major specialty areas: gastroenterology and microbiology/infectious diseases. While the National Institute for Health and Care Excellence (NICE) guidance (2014) for use of FMT for recurrent or refractory CDI has become accepted in the UK, clear evidence-based UK guidelines for FMT have been lacking. This resulted in discussions between the British Society of Gastroenterology (BSG) and Healthcare Infection Society (HIS), and a joint BSG/HIS FMT working group was established. This guideline document is the culmination of that joint dialogue.
Keywords: colonic microflora; enteric bacterial microflora; infective colitis; inflammatory bowel disease; intestinal microbiology.
Conflict of interest statement
Competing interests: THI acted as a consultant, advisor or speaker for Pharmacosmos and Shield Therapeutics. ALH acted as a consultant, advisory board member or speaker for AbbVie, Atlantic, Bristol-Myers Squibb, Celltrion, Falk, Ferring, Janssen, MSD, Napp Pharmaceuticals, Pfizer, Pharmacosmos, Shire and Takeda. ALH also serves on the Global Steering Committee for Genentech. SDG received consultancy fees, speaker fees and research grant support from Astellas between 2015 and 2017; received consultancy fees and speaker fees from MSD between 2015 and 2017; and received consultancy fees in 2017 from Pfizer.
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Source: PubMed