Microbiota transfer therapy (MTT) – the procedure commonly known as faecal transplantation – is one of the most effective, non-invasive ways of treating recurrent Clostridioides difficile infection. The European and American professional guidelines both recommend it when the disease recurs. You do not have to face it alone — we accompany you from the first question to recovery.
Short answer. Microbiota transfer – commonly known as faecal transplantation – is primarily considered in recurrent C. difficile (Clostridioides difficile) infection, after a second or further recurrence, on the basis of the earlier antibiotic treatments and the patient's condition, in consultation with the treating physician. The first step is the free pre-screening and a review of the earlier findings.
If it has already recurred several times, you know how exhausting it can be.
The Clostridioides (Clostridium) difficile is a toxin-producing bacterium. When the balance of the gut flora is disrupted — typically after a course of antibiotics — it can multiply and cause a stubborn, often recurrent diarrhoeal infection (CDI).
The infection typically runs like this: during the antibiotic course the symptoms disappear, then return one or two weeks after the treatment has ended. This may be followed by another course and another relapse. Every cycle reduces the diversity of the gut flora, and after each recurrence the chance of the next one is greater.
MTT tries to break this cycle: it does not kill the bacterium, but restores the microbial community that keeps the pathogen from multiplying. On this page we set out who the procedure helps, what happens when, what it costs, and where its limits lie.
This is not a diagnosis and does not replace a medical examination — but in one minute it shows whether it is worth getting in touch with us.
A fulminant, life-threatening course — high fever, marked abdominal pain, circulatory instability, suspected toxic megacolon or bowel perforation — requires immediate hospital care. With severe immunosuppression, active oncological treatment or inflammatory bowel disease we assess the treatment individually, together with the treating physician. If you are uncertain, ask for a telephone consultation and in 15 minutes we will inform you about the options. If we see that we cannot help, we will say so honestly.
So that you know when things happen and where the decision points are.
Getting in touch, registration. From the symptoms, the test results and the previous treatments we calculate your SIS score. This decides the starting dose with which the treatment begins. We assemble the capsules ordered within 72 hours and hand them over to the courier service ready for shipping.
The starting dose is derived from the SIS score, and we keep it unchanged during the initial phase. The exact length and the pace at which the dose is adjusted are set by a predefined protocol, but may vary according to the individual condition and consultation with the treating physician. The detailed protocol is set out in the downloadable professional document. You need to record your symptoms daily using an online questionnaire, which takes 7–8 minutes.
If the symptoms have settled durably, the gradual tapering begins: the dose is reduced in steps, according to a predefined protocol. Decision mechanism: we reduce, we hold the dose, or — if there is no response beyond 48 hours — we escalate to the band maximum.
We provide an online consultation with our exposome specialist and fine-tune the protocol in consultation with the treating physician. Decision: we maintain the treatment, we modify it, or we refer you back to your treating physician. We do not build in automatic repetition.
The same sequence as on the timeline above. At every stage you will know what the next step is — getting from registration to a personalised protocol can take as little as 20 minutes in all.
Fill in the form or ask for a call back. In a free, 15-minute conversation we clarify whether it makes sense to start in your case. If we see that it does not, we will say so.
→We will send you a link in an information e-mail with which you can register as a patient. At that point you will receive a unique identifier from us in P0000000 format, which we will always refer to during the further administration.
By filling in a short questionnaire you tell us about your symptoms, your previous treatments, the number of recurrences and your expectations of MTT.
The The Symptom Importance Scale helps us assess your current condition and propose a personalised protocol. Filling it in is extremely simple: all we need is your medical history and the laboratory results already available.
We assemble the capsules ordered within 72 hours and hand them over to the courier service ready for shipping.
During the therapy we track the symptoms with the online questionnaire. If they have not eased after 15 days, we provide an online consultation and fine-tune the protocol in consultation with the treating physician.
You do not have to decide about the whole process at once. After every step you have the opportunity to assess the results achieved.
| Step | What we provide | Price | Must you continue? |
|---|---|---|---|
| 1. Call back and pre-screening | A 15-minute conversation, clarifying suitability | free of charge | no |
| 2. Condition assessment (SIS) | 23 weighted variables, based on four validated medical models; a personalised protocol recommendation | free of charge | no |
| 3. DiffBiome course 30 capsules, treatment at home | At the dose given by the SIS score, with gradual tapering and follow-up | €1,140 / 30 capsules + shipping cost | – |
| 4. HospBiome 5-capsule pack | For the treatment of patients cared for in hospital, by institutional order only | by individual agreement | – |
| Item | Included? |
|---|---|
| Call back and pre-screening (15-minute conversation) | yes — free of charge |
| Condition assessment (SIS score) | yes — free of charge |
| Appearing in person | is not necessary — the process is remote throughout |
| The capsules in the packaging unit ordered | yes — at the price in the table above |
| Shipping cost | no — the delivery charge is separate |
| Follow-up during the course | yes |
| Joint closing assessment and tapering-off plan | yes |
| Examination by the treating physician, laboratory tests | no — these take place at your own healthcare provider |
The same high-quality donor microbiota, processed in a certified laboratory — in two formats, tailored to your situation.
The C. difficile infection is the best-established indication for FMT. The first randomised trial, in 2013, was stopped earlier than planned, because the difference between the effect of donor stool and that of the antibiotic was so large in favour of FMT that further randomisation was judged unethical.29
The capsule form is equivalent to colonoscopy. In a randomised trial of 116 patients, 12 weeks after a single treatment 96.2% of patients had no recurrence of the infection — the same proportion as with the colonoscopic procedure.8 The figure refers to the method, not to a specific product.
The professional guidelines recommend it. Both the ESCMID 2021 guidance and the IDSA/SHEA 2021 update recommend FMT over standard antibiotic treatment for second and further recurrences.17, 28
The safety data are reassuring in the long term as well. A study of 609 patients with a median follow-up of 3.7 years and the ten-year follow-up of the original randomised trial both found no late event attributable to FMT.87, 30 This does not mean, however, that there is no risk: mild, transient complaints related to the procedure are common.
The Clostridioides difficile is a toxin-producing bacterium that can also be present alongside a healthy gut flora without causing trouble. The infection develops when this balance is disrupted — typically after a course of antibiotics. An intact microbial community maintains colonisation resistance in the gut: it takes away the nutrients, produces inhibitory metabolites, and creates a bile-acid pattern in which the spores of C. difficile cannot germinate.
Schematic diagram. Colonisation resistance is the combination of several parallel mechanisms; the diagram highlights the three best documented. The details of the process and the studies cited are discussed on the scientific background page.
The Microbiota transfer therapy (MTT) — commonly known as faecal transplantation — involves delivering gut microbiota from a thoroughly screened, healthy donor in capsule form so that this protective net can be restored. For more on this, the Microbiota Guide and the Microbiota Handbook are worth reading.
Every donor undergoes bacteriological, virological, parasitological and serological testing, stool testing and detailed medical-history screening under the DSQ donor screening framework.
Every capsule we ship carries a LOT number (a manufacturing batch identifier), so it can be traced back to the donor at any time.
We do not estimate the starting dose: the SIS score is established from 23 weighted variables on the basis of four validated medical models, and it ties the treatment intensity to a band.
We do not start a protocol without a treating physician. The capsule is in every case prescribed by the treating physician.
We track the symptoms throughout the course with an online questionnaire. If they have not eased after 15 days, we provide an online consultation and modify the protocol in consultation with the treating physician.
In the studies, mild, transient complaints related to the procedure are common (bloating, abdominal discomfort, transient diarrhoea, slightly raised temperature); serious events are rare.
The success of the treatment depends on the bacterial concentration and the length of the treatment — and this differs from patient to patient. We determine the appropriate dose on the basis of the SIS (Symptom Importance Scale) score: this scoring system turns your symptoms, your laboratory results and your risk factors into a single number on a 0–100 scale.
You do not have to fill it in on your own. From the questionnaire and your test results we calculate it and show you which band your case falls into. The band decides the dose strength we start with, how long the initial phase lasts, and from when it can be reduced. The more severe the condition, the higher the starting dose and the longer the course; as your condition improves, the dose is reduced in steps.
The Symptom Importance Scale turns your symptoms, laboratory results and risk factors into a single number in the 0–100 range. This document describes the bands, the treatment intensity belonging to each, and the rules for reducing the dose. You can also take it with you to your treating physician.
If you are a treating physician, or the patient asks you for an opinion: treatment follows the MTT Clinical Protocol Guide v7.1 which sets out patient selection, dose determination, the rules of escalation and gradual tapering, donor screening requirements and the follow-up steps. Referring a patient requires no separate agreement: a single message is enough and we will initiate the professional consultation.
Write briefly about the problem you are turning to us with and, if there is one, who referred you to us. We will review whether it makes sense to start in your case — and if we see that it does not, we will say so.
MicroBiome Bank does not sell products; it connects donors and recipients by providing professional medical services: it organises the recruitment of donors and their screening in a certified laboratory, the stool tests, and the processing of the screened donation into capsule form. The contents of the capsules remain the property of the donor until the recipient has paid in full. The brand names of the services serve to make them easier to remember. We deliver the capsules “to the doctor’s hand”, and they are to be used under the guidance of a treating physician. For detailed information, please contact us. The MicroBiome Bank service is not a substitute for professional medical advice, diagnosis or treatment. The decision to use it rests in every case with the treating physician.