What does it mean for FMT capsules?
This is how a treatment is built – from the stool sample to the standardized capsule.
During fecal microbiota transplantation (FMT), we use approximately 150 grams of thoroughly filtered donor stool. This sample contains beneficial bacteria in very high concentration, which are key to restoring the gut flora.
1 capsule = 1/1200 of the full stool dose — this is what we call a standard (1×) density capsule.
The density of a capsule indicates how much bacteria it contains compared to the standard (1×) capsule. From the same 150 g sample, capsules of different densities can be produced: the fewer capsules we divide it into, the more concentrated each one is.
| Notation | Density | Capsules from 150 g | Typical use |
|---|---|---|---|
| I | 1× (Standard) | 1200 | Long-term gut flora restoration |
| II | 2× (Double) | 600 | Common, default dose |
| V | 5× | 240 | Medium-intensity treatment |
| X | 10× (Tenfold) | 120 | Intensive modulation |
| XX | 20× | 60 | Severe case, rapid intervention |
| L | 50× | 24 | Maximum concentration, hospital use |
The higher the density, the fewer capsules are needed – but the more effective and more costly the dose.
The physician always selects the density of the capsules individually, based on the following:
As an example, the treatment strategy for Clostridioides difficile infection:
This so-called "hyperbolic treatment model" makes it possible to address the severe infection and the underlying dysbiosis at the same time – in a personalized way.
The success of the treatment depends on two factors: the bacterial concentration used (the density of the capsule) and the duration of the treatment. The same therapeutic load can be achieved with few, high-density capsules over a short period – or with more, low-density capsules over a longer period. The relationship between the two is what we call the hyperbolic curve: as the density increases, the required number of capsules and the time decrease, tapering off onto an increasingly flat "foot".
High density (e.g. XX or L), few capsules, short course – rapid, life-saving intervention, e.g. in severe C. difficile infection.
Low density (e.g. I or II), more capsules, longer course – gradual, lasting restoration of the underlying gut flora balance.
Choosing the right point on the curve is not arbitrary: it is based on the Symptom Index Scale (SIS), which scores the symptoms reported by the patient, the laboratory results, previous treatments and known risk factors. In the case of Clostridioides difficile infection, the system combines four validated clinical models – the Zar score, the ATLAS model, the Hines VA severity score and the CARDS model – so that the dose and the duration are matched to the actual severity of the disease.
In this way, both the severe, acute infection and the underlying dysbiosis can be addressed at the same time – in a personalized way, balancing clinical efficacy, patient tolerance and cost.
To make treatments more economical and to ensure stable quality, we often combine several donations from the same donor (typically 4–5 samples).
This innovation is what makes our treatments scalable and affordable – without having to compromise on quality or safety.
We determine the treatment protocol based on the diagnosis and the severity of the dysbiosis, the patient's financial means and capsule tolerance, and the goal of the treatment (acute intervention or long-term restoration).
60 capsules, at double density – a common, default dose for chronic conditions.
Just 5 capsules, at twentyfold density – for severe, hospital cases.
For recurrent C. difficile infection, from pooled lyophilizate.
The higher the density, the fewer capsules are needed – but the higher the price per capsule. Treatment is always built on a balance of clinical efficacy, patient needs and cost.
Whether you are a physician looking for a reliable and scalable solution, or a patient who wants to better understand your options – we can help. Explore the capsule range of our services, or request a consultation.
View our capsules Get in touchIn the course of providing the Capsule service, MicroBiome Bank cannot and does not intend to verify the authenticity of the identity and/or medical indication provided. By ordering the service, the customer accepts that the laboratory will perform the service ordered under the name provided by the customer on a donor sample tested by the laboratory and donated under the code number given to the customer. Processing is individual, and the finished capsules can be identified in a verifiable manner by a tracked code number. By ordering the capsules, the customer declares that the capsules delivered to them marked "To the physician's hand" will be used under the direction of their treating physician. Any effect arising from the intentional or unintentional transfer of incorrect information, or the disclosure of false information, is solely the responsibility of the customer.