Protocols approved Use of FMT

Fecal Microbiota Transplant (FMT) Policy

Investigational drug.  Restricted to Infectious Disease and Gastrointestinal specialists. 

Procedures for Pharmacists:

1. The verifying pharmacist is responsible for entering a pharmacokinetic (PKS) consult into the EMR when receiving an order for FMT from a physician
2. The verifying pharmacist may then process the order- may add comment to order “FMT PKS Notified” if desired
3. AMT pharmacist will follow FMT consult and arrange delivery of FMT product to designated area on the day of procedure
4. AMT pharmacist will verify that the prescribing physician has consented the patient for FMT therapy and the AMT pharmacist will then get the signed informed consent document to be placed in the FMT binder
5. AMT pharmacist will confirm Clostridium difficile antibiotics are discontinued from patient’s profile 48 hours prior to FMT administration, if FMT to be administered in the hospital
6. AMT pharmacist will enter pantoprazole order per protocol if patient receiving FMT via capsule formulation or via NG tube in hospital
7. AMT pharmacist will enter associated FMT drug orders into EMR based on product/formulation selection by prescribing physician
8. On the day of procedure, the AMT pharmacist will label and deliver FMT to the designated area for administration

Reviewed: 24 May 2016 (Order Sets and Protocols)

• Micromedex
• UpToDate
• Lippincott Advisor