Who is a candidate for FMT?
Current FDA guidance permits fecal microbiota transplantation only for the treatment of C. difficile infection that is not responsive to standard antibiotic therapy. According to the American Gastroenterological Association, FMT may be an option for people who have had one of the following:
- At least three episodes of mild to moderate C. difficile infection that have not responded to six to eight weeks of treatment with antibiotics.
- Have had at least two episodes of severe C. difficile infection that required them to be admitted to the hospital.
- Moderate C. difficile infection that did not respond to antibiotics (namely vancomycin) for at least a week.
- Severe C. difficile infection or severe colitis caused by C. difficile that did not respond to antibiotics within two days.
Physicians who wish to perform FMT for any other disease must file an Investigational New Drug (IND) application with the FDA or do so under a clinical research trial. You can read more about the federal regulations surrounding FMT here.
Moreover, patients who are immunocompromised may not be good candidates for FMT. The procedure is risky for people who are taking drugs that suppress their immune system, have had a recent bone marrow transplant, or have cirrhosis of the liver or advanced HIV or AIDS. If you fall into one of these categories, your doctor may advise against it, depending on how severe your C. difficile infection is and whether you have other complications.