The US Food and Drug Administration (FDA) has classified human stool as a biological agent and determined that its use in fecal microbiota transplantation (FMT) therapy and other research should be regulated to ensure patient safety.
To use FMT to treat recurrent Clostridium difficile infection (RCDI), an investigational new drug (IND) permit is not required, but is strongly encouraged and may ultimately be required.
To use FMT for research or to treat any condition other than RCDI, an IND permit is required.
The FDA has continued to review the FMT enforcement policy since July 2013, and will be issuing clarifying guidance in the near future. The DRAFT of Guidance for Industry: Enforcement Policy Regarding Investigational New Drug Requirements for Use of Fecal Microbiota for Transplantation to Treat Clostridium difficile Infection Not Responsive to Standard Therapies (PDF) is available for review. This guidance document has not been finalized by the FDA and is intended for comment purposes only.
"Fecal Microbiota Transplantation: A Practical Update for the Infectious Disease Specialist," Clinical Infectious Diseases, published 2013.
"Investigational New Drug forms and Instructions," FDA.gov, updated 2010.
United States Fecal Microbiota Transplantation Provider Sites, Google Maps, updated 2014
Complete the FDA forms: Three copies required.
Mail all documentation to:
Food and Drug Administration, Center for Drug Evaluation and Research
Therapeutic Biological Products Document Room5901-B Ammendale Road Beltsville, MD 20705-1266
More submission information from the FDA >>
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