Compositions for fecal floral transplantation and methods for making and using them and devices for delivering them
The present disclosure provides compositions, e.g., formulations, used for gastric, gastrointestinal and/or colonic treatments or lavage, e.g., orthostatic lavage, e.g., for inducing the purgation (e.g., cleansing) of a gastrointestinal (GI) tract, including a colon. compositions of the invention are used for the stabilization, amelioration, treatment and/or prevention of constipation, for the treatment of abdominal pain, particularly non-specific abdominal pain, and diarrhea, including diarrhea caused by a drug side effect, a psychological condition, a disease or a condition such as Crohn's Disease, a poison, a toxin or an infection, e.g., a toxin-mediated traveler's diarrhea, or C. difficile or the pseudo-membranous colitis associated with this infection.
1. A pharmaceutical composition comprising a microbial formulation comprising (i) uncultured bacteria extracted from a stool of a healthy human donor, and (ii) a cryoprotectant, wherein the microbial formulation does not contain rough particulate matter of the stool, wherein the proportion of bacteria from the phylum Firmicutes relative to non- Firmicutes bacteria in the microbial formulation is greater than such proportion in the stool.
2. The pharmaceutical composition of claim 1 , wherein the cryoprotectant comprises glycerol.
3. The pharmaceutical composition of claim 1 , wherein the microbial formulation is formulated as a liquid.
4. The pharmaceutical composition of claim 3 , wherein the liquid is a saline suspension.
5. The pharmaceutical composition of claim 1 , wherein the microbial formulation is encapsulated by a capsule.
6. The pharmaceutical composition of claim 5 , wherein the capsule is acid-resistant.
7. The pharmaceutical composition of claim 5 , wherein the capsule is an enteric-coated capsule.
8. The pharmaceutical composition of claim 1 , administered to a subject to treat a Clostridium difficile infection in the subject.
9. A capsule comprising a microbial formulation comprising a suspension of uncultured bacteria in a cryoprotectant, wherein the uncultured bacteria are from a human stool, wherein the uncultured bacteria are separate from rough particulate matter of the human stool, wherein the proportion of bacteria from the phylum Firmicutes relative to non- Firmicutes bacteria in the microbial formulation is greater than such proportion in the human stool.
10. The capsule of claim 9 , wherein the cryoprotectant comprises glycerol.
11. The capsule of claim 9 , wherein the suspension is a saline suspension.
12. The capsule of claim 9 , wherein the capsule is acid-resistant.
13. The capsule of claim 9 , wherein the capsule is an enteric-coated capsule.
14. The capsule of claim 9 , administered to a subject to treat a Clostridium difficile infection in the subject.
15. The capsule of claim 9 , wherein the human stool is pre-screened for infectious agents.
16. The capsule of claim 9 , wherein an amount of non-floral material of the human stool in the suspension is no greater than 1%.