Her son had been sick for four months when Blanca Morales started asking about a transplant. It had started with a case of strep throat from Mundo’s first-grade class — routine enough, treatable with antibiotics. Then he started having stomach trouble.
The illness had likely been sparked by strep-fighting antibiotics back in March 2025, the bacterial community of Mundo’s colon wiped out, allowing the heartier, toxin-spewing C. diff to proliferate — a microscopic strongman taking advantage of a microbial power vacuum.
At the end of 2024, the Food and Drug Administration had halted shipments from a major supplier of fecal transplant material, a national stool bank called OpenBiome. That left kids like Mundo with fewer options. “It shouldn’t be this hard to cure a child,” Morales said.
But then in 2022 and 2023, two companies secured FDA approval for human-excrement-derived drugs to prevent C. diff. recurrence. But the two drugs weren’t approved for kids, the immunocompromised, or those whose C. diff is severe.
They were also expensive, often far more than a transplant. According to First Databank, Vowst’s list price is $19,680 for 12 pills and Rebyota’s is $9,411 for one enema bag. Insurers sometimes balked at covering them even for the intended patients. The denials were only more vociferous at the idea of using them off-label for someone like Mundo. An FDA approval was supposed to protect patients — and in theory, make effective treatments more accessible. In the real businessy world of American health care, that wasn’t always how it worked out.
