Clostridium difficile: Fecal microbial transplantation more effective
and less costly than antibiotics

Date:
June 29, 2020
Source:
University of Birmingham
Summary:
An innovative treatment for patients with Clostridium difficile
infection (CDI) which uses transplanted gut bacteria to treat the
infection, is a more effective and more cost-efficient treatment
than using antibiotics, a new study has found.



FULL STORY ==========================================================================
An innovative treatment for patients with Clostridium difficile infection
(CDI) which uses transplanted gut bacteria to treat the infection, is a
more effective and more cost-efficient treatment than using antibiotics,
a new UK study has found.


==========================================================================
CDI is an infection of the bowel, which commonly affects people who have recently been treated in hospital, those with underlying conditions and patients over 65. Almost 30 per cent of patients treated for the condition experience at least one recurrence. A recurrence of the condition, has
been associated with a higher risk of mortality and is usually treated
using antibiotics.

Faecal microbial transplantation (FMT), a treatment pioneered as a
licenced medicine by Professor Peter Hawkey and his team at the University
of Birmingham, is a method where gut bacteria and other components in
faeces are used to treat CDI. The bacteria is taken from a screened
healthy donor, processed and screened before being transplanted via a
tube passed through the nose into the stomach. Treatment with FMT is
associated with higher cure and lower recurrence rates than fidaxomicin
or vancomycin- the two most common antibiotics used to treat recurrent
CDI (rCDI).

The study, which presents the first decision model for patients with rCDI already hospitalised in the UK, analysed randomised controlled trials, observational studies and expert opinion from the UK, on patients with
single or multiple rCDI. Researchers analysed the cost of each of the
four treatment options for rCDI for treatment effects, unit costs,
resource and health related quality of life to identify which treatment
was the most cost-effective and offered the best outcome for patients.

The study showed that both methods for administering FMT were lower in
cost compared to standard treatment with antibiotics. FMT via naso-gastric
tube was the least costly, with a mean cost of -L-8,877 per patient, while
FMT via colonoscopy was -L-11,716 per patient. FMT via colonoscopy was
also shown to be slightly more effective than treatment via naso-gastric
tube, offering patients a higher quality of life. Two other standard
antibiotic treatments vancomycin and fidaxomicin were compared in the
model but both these treatments were shown to be more costly and less
effective than either of the FMT interventions.

Moreover, Vancomycin was the most expensive and the least effective
treatment.

Professor Peter Hawkey, formerly of the University of Birmingham said,
"We at the University of Birmingham pioneered this treatment as the
UK's first third party FMT service. FMT is not currently a widespread
treatment for this disease but by showing that it not only saves lives,
but is also significantly more cost effective, we hope that this could be
one of the first steps towards the treatment being accepted more widely." Professor Tracy Roberts, Head of the University of Birmingham's Health Economics Unit said "As well as being more effective both in terms of
cost and benefit to patients, FMT was shown to significantly reduce the
amount of days patients were required to be hospitalised which could
also provide longer term cost-savings"

========================================================================== Story Source: Materials provided by University_of_Birmingham. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Zainab I Abdali, Tracy E Roberts, Pelham Barton, Peter M
Hawkey. Economic
evaluation of Faecal microbiota transplantation compared to
antibiotics for the treatment of recurrent Clostridioides difficile
infection.

EClinicalMedicine, 2020; 24: 100420 DOI:
10.1016/j.eclinm.2020.100420 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/06/200629120129.htm

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