Capsules can cure C difficile – but don't ask what's in them

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The potentially deadly hospital infection Clostridium difficile (C difficile) can be treated using capsules of frozen faeces from healthy people, an American study has found.

The gut bug is one of the most feared "hospital infections". It can be difficult to treat and deadly, especially in the elderly. US researchers were able to cure 18 out of 20 C difficile patients of diarrhoea and significantly improve their condition.

"Stool transplants" from healthy patients have previously been shown to restore normal balance, but had involved invasive procedures to administer.

Doctors at Massachusetts General Hospital in Boston were instead able to freeze healthy stool samples and enclose them in capsules that could be swallowed. The findings could be significant because C difficile is difficult to combat with antibiotics. Treatment failure is common.

C difficile is harmless in healthy people, but some antibiotics upset the natural balance of bacteria in the gut that would normally protect against an infection, leading to C difficile multiplying and producing toxins which cause diarrhoea and can lead to fatal complications such as swelling of the bowel.

It occurs most commonly in hospital patients undergoing courses of antibiotic treatment. The bacteria is carried in faeces and can survive on objects and surfaces for weeks.

A spike in the number of cases, as well as those of another hospital infection, methicillin-resistant Staphylococcus aureus (MRSA), forced the NHS to introduce stringent new infection-control measures which have significantly reduced the number of C difficile cases since nationwide monitoring was introduced in 2007. There were 13,361 cases in England from April 2013 to March 2014, compared with 52,988 in 2007.

As well as being cured of diarrhoea, the patients in the study reported significant improvements in overall health. Asked to rate their condition on a scale of one to 10, patients reported an improvement from an average of five before treatment to eight after taking the capsules.

The study is published the Journal of the American Medical Association.