Reducing infections
with the right composition of microbiota extract
The emergence and proliferation of a toxin-producing variant of the bacterium clostridioides (clostridium) difficile (c. diff.) can lead to a life-threatening infection. This most often occurs in the presence of prolonged antibiotic therapy or hospitalisation, with predisposing conditions that weaken immune defences. The bacterium spreads by upsetting the healthy microbiota balance, causing a clinical picture of fever, abdominal pain, vomiting and diarrhoea.
Treatment of toxin-producing (A/B or C) Clostridioides (Clostridium) difficile infections is nowadays increasingly performed with MTT (microbiota transfer therapy) to overcome the increasing antibiotic resistance and the resulting dysbiosis. If you have previously had an infection confirmed by microbiological testing (stool culture and/or c. diff. toxin detection from a stool sample), a decision on treatment can be made in the light of your symptoms in case you have a recurrent infection.
Our stool microbiota transformation service for the treatment of Clostridioides (Clostridium) difficile infection is called DiffBiome and is available in 3 (three) different versions, which are listed in the table at the bottom of this page.
Comparative Analysis of MTT and Antibiotics
Orvosi háttér
Clostridium difficile infection (CDI) poses a significant challenge in modern healthcare, requiring effective and cost-efficient treatment strategies. Below we aim to provide a comprehensive analysis of two primary treatment modalities: Microbiome Treatment Therapy by FMT and antibiotics. Traditional antibiotic therapy, while many times effective, has been linked to high recurrence rates, leading to the exploration of alternative treatments such as MTT.
MicroBiota Treatment Therapy (MTT)
Pros
Cons
- High Cure Rates: MTT has demonstrated superior efficacy in treating recurrent CDI, with cure rates exceeding 86%.
- Microbiome Restoration: MTT restores the balance of gut microbiota, promoting long-term resilience against CDI recurrence.
- Reduced Antibiotic Dependency: MTT reduces reliance on antibiotics, potentially mitigating antibiotic resistance concerns.
- Long Term Financial Benefits: MTT may have higher initial costs due to donor screening, laboratory testing, and procedural requirements, but due to its higher cure rates, application may lead to long-term cost savings by reducing the need for repeated courses of antibiotics and hospital readmissions.
- Limited Standardization: Due to the nature of MTT, the microbiome of each donor changes every day, every hour, and therefore, unlike drugs, it cannot be standardised. MTT lacks standardized protocols, leading to variability in clinical outcomes.
- Risk of Infection Transmission: There is a minimal risk of transmitting infections from the donor to the recipient, emphasizing the need for rigorous donor screening.
Antibiotics
Pros
Cons
- Widespread Availability: Antibiotics are readily available and can be administered orally or intravenously, ensuring ease of use.
- Cost-Effective: Antibiotics are generally more cost-effective in the short term compared to MTT. But this only holds until the first reoccurrence.
- High Recurrence Rates: Antibiotic therapy is associated with higher recurrence rates, requiring prolonged and repeated courses.
- Disruption of Microbiota: Antibiotics not only target the pathogen but also disrupt the healthy gut microbiota, potentially leading to dysbiosis.
- High Long Term Costs: Antibiotics are generally more affordable initially, but antibiotic-related complications, such as adverse reactions, recurrent infections and prolonged hospital stays for extended treatment durations as well as change of antibiotics may cause costs to escalate rapidly.
Conclusion
In conclusion both MTT and antibiotics play a crucial roles in managing CDI, each with its set of advantages and disadvantages. MTT offers superior efficacy and microbiome restoration, potentially translating into long-term financial benefits. Antibiotics, while more accessible and cost-effective initially, come with higher recurrence rates and hidden costs. For mild infections, it is in the best interest of the patient to wait. In cases where oral or iv. antibiotics is to be administered, given the price of Vancomycin, Fidaxomycin and Bezlotoxumab, the patient and the institution will experience a financial benefit when chosing MTT over standard AB therapy.[3]
[3] https://pubmed.ncbi.nlm.nih.gov/33878506/
Treating Clostridioides (Clostridium) difficile infections with DiffBiome capsules
Please choose the treatment period (5 or 10 days) or the increased bacterial density for recurrent disease, based on the severity of the infection and the advice of your doctor. The usual duration of treatment is 5 days, during which time it is recommended to take 3 capsules per day. For patients with severe symptoms, especially those who have repeatedly failed antibiotic therapy, we recommend the use of double bacterial capsules and increasing the treatment period to 10 days.
It is also recommended that you suspend all anitibiotic and probiotic therapy for at least 3 days before MTT, as these may neutralise or adversely affect the outcome of the treatment. Double-density capsules are specifically recommended for the treatment of recurrent, therapy-resistant cases where avoiding further fluid loss is essential.
Usual administration: 2-3 capsules for 5 days, followed by a 3 day break. When using DiffBiome, it is not necessary to keep a food and complaint diary or to perform a compatibility test.
Notice!
Our default (DiffBiome (30N)) service is provided on a continuous basis. If the type of processing you have ordered takes longer, we will inform you of the expected date of completion and delivery. The prices shown do not include the cost of delivery, which must be selected at the time of ordering. The prices indicated for each service include discounts for registration or contract, which must be provided in the "Promotion code" field. List prices are available by clicking on the "Order" button.
If you wish to register, you can do so by clicking on the button below. After registration, please wait for our colleagues to activate the discount for you! You can then order the service directly by pressing the button under the capsule.
475€
/ box
DiffBiome (15D)
(1x15 capsules)- Whole microbiome suspension of human origin from screened donor, in lyophilized form
- Sufficient for a 5-day treatment
- For treating Clostridioides (Clostridium) difficile infections
- Double bacterial density
475€
/ box
DiffBiome (30N)
(1x30 capsules)- Whole microbiome suspension of human origin from screened donor, in lyophilized form
- Sufficient for a 10-day treatment
- For treating Clostridioides (Clostridium) difficile infections
- Standard bacterial density
765€
/ box
DiffBiome (30D)
(1x30 capsules)- Whole microbiome suspension of human origin from screened donor, in lyophilized form
- Sufficient for a 10-day treatment
- For treating Clostridioides (Clostridium) difficile infections
- Double bacterial density
Click on the appropriate button to be redirected to our payment page where you can finalise your order for our services. Once the payment has been received, our staff will contact you by e-mail and send the DiffBiome package of your choice labelled " To the doctor's hand" to the address you provided during the purchase. Please note that although we provide you with the highest quality laboratory certified service, the administration of DiffBiome capsules and the evaluation of the results may require professional experience. Please do not hesitate to contact us if you have any questions!
Notice!
We recommend that you consult your doctor before ordering individual capsules. MicroBiome Bank does not provide patient care, the aim of the consultations is to develop a treatment protocol for each patient, which can be most effectively applied by the doctor of the specialty.
Precautions
Ensure that for the duration of MTT the patient:
- is not taking antibiotics or probiotics;
- should only consume antibiotic and antihelminthic-free animal protein and avoid artificial sweeteners;
- should eat foods containing live bacteria (live-flora dairy products, lacto-fermented vegetables).
Microbiota Transfer Therapy (MTT) is currently the most effective method of treating recurrent Clostridium difficile infection and is the most capable of restoring natural function. It is extremely safe when used in accordance with professional standards and MTT guidelines. The use of MTT reduces the likelihood of recurrent infections, while improving the diversity of the gut microbiota as a beneficial side effect.
The course of treatment
There is no significant difference in efficacy between the two routes of administration (capsule and enema), so oral administration is recommended in terms of treatment invasiveness, equipment and human resources required, as well as cost of care. [1]
Treatment plan
The dosage should always be adjusted to the symptoms: 2 capsules per day by default, 3 capsules per day in severe cases.The first treatment cycle is always 7 days and we do not recommend interrupting it. If the number of daily bowel movements decreases significantly during this period, the consistency of the stools passed improves and the number and intensity of bowel movements and cramps decreases, treatment should not be continued after day 7. Any capsules remaining from the treatment should be stored in a freezer and can be used within 24 months of opening in the event of a relapse.
Interpreting results
If the symptoms are reduced, but some elements of the symptoms persist, the treatment should be continued up to the maximum of 30 capsules per box, while increasing the dose to the maximum (3 capsules per day). No further improvement can be expected after the 15th day or after the 30 capsules have been taken and therefore a professional consultation is considered necessary before continuing treatment.
Changing donor
If the MTT with a given donation has not produced the desired result or if there is no complete remission of certain elements of the symptom complex, it is advisable to seek another donor to increase microbiota compatibility. The use of MTT from a new donor should be performed as described in the 'Treatment plan' section.
[1] https://pubmed.ncbi.nlm.nih.gov/30388112/
€475/ box
DiffBiome (30N)
(1x30 capsules)- Whole microbiome suspension of human origin from screened donor, in lyophilized form
- For treating Clostridioides (Clostridium) difficile infections
- Standard bacterial density
- Sufficient for a 10-day treatment
- In the form of MTT suspension
- May be prescribed on the basis of indication
Disclaimer
MicroBiome Bank cannot and will not verify the validity of the identity and/or medical indication you have provided for the DiffBiome service. By placing an order, the person using the service accepts that the laboratory will perform the service ordered under the given name on the donor sample tested by the laboratory and donated to the customer under the given code number, by means of individual processing and filling it into DiffBiome capsules that may be identified by a code number that is verifiably recorded. When ordering the DiffBiome capsules, the customer declares at the same time that he will use the capsules delivered to him labelled "To the doctor's hand" under the supervision of a qualified medical practitioner. Any effects resulting from the deliberate or negligent communication of incorrect information or misrepresentation by the customer shall be the sole responsibility of the customer.
Complications of microbiota transfer therapy
Most clinical trials and systematic reviews demonstrated that some minor adverse events, like abdominal discomfort, diarrhea, constipation, and low-grade fever, were transiently observed post FMT, whereas uncommon severe side effects were often related to the possible complications of endoscopy and sedation. [1], [2].
[1] Wang JW, Kuo CH, Kuo FC, Wang YK, Hsu WH, Yu FJ, Hu HM, Hsu PI, Wang JY, Wu DC. Fecal microbiota transplantation: review and update. Journal of the Formosan Medical Association. 2019 Mar 1;118:S23–S31.
[2] Rossen NG, MacDonald JK, de Vries EM, D'Haens GR, de Vos WM, Zoetendal EG, Ponsioen CY. Fecal microbiota transplantation as novel therapy in gastroenterology: a systematic review. World journal of gastroenterology: WJG. 2015 May 7;21(17):5359.