The Infection-Busting Treatment Payers Don't Want to Talk About

Christopher Cheney, for HealthLeaders Media , July 23, 2014

Fecal microbiota transplantation is an inexpensive treatment for a potentially deadly infection. But FMT is not for the squeamish. It's time for payers to get on board with this antibiotic alternative, which has a 90% cure rate.

First the good news about Clostridium difficile, the deadly bacteria that can take over the gut of hospitalized patients after their natural gastrointestinal flora has been decimated by antibiotics: There's an inexpensive and highly effective treatment for it.


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C. diff, which is antibiotic-resistant, causes diarrhea that contributes to the deaths of about 14,000 Americans this year, according to the federal Centers for Disease Control and Prevention. It's also a cause of costly hospital readmissions, with about a quarter of infected patients experiencing at least one relapse within a month after completing antibiotic treatment.

Now the bad news: The inexpensive treatment with a 90% cure rate—fecal microbiota transplantation—is not for the squeamish.

There are reports of fecal transplantation in early Chinese medicine, but the earliest documented instances of the procedure in Western medicine date back only to the 1950s. Now researchers are trying to isolate the beneficial microbiota that seek and destroy C. diff.

One Mayo Clinic researcher likens exploration of the uses of gut microbiome in disease treatment to "the beginning of the space program."

Microbiome as 'Miracle Cure'
"Our patients have failed all other therapies," Lee Jones, founder, CEO and president of Rebiotix, told me this week. The Roseville, MN-based company is developing a fecal matter suspension that can be delivered to a C. diff patient's GI tract with an enema. The shelf-stable product, RBX2660, is in the final stage of testing at the federal Food and Drug Administration.

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