Can Oral Microbiome Therapy Break the Cycle of Recurrent Clostridioides difficile Infection?

Post-hoc analysis of an open-label study points to enhanced GI microbiome diversity and altered primary and secondary bile acid concentrations after therapy with VOWST.

Up to one quarter of patients with Clostridioides difficile infection (CDI) develop recurrent disease, presumably due to a disturbance of the gastrointestinal (GI) microbiome that is not corrected by antimicrobial treatment. In a prior double-blind study, risk for recurrent CDI after antibiotic therapy was reduced by oral administration of purified Firmicutes spores (VOWST). Such therapy has been hypothesized to prevent recurrence because it augments GI microbiome diversity and promotes a switch from primary bile acids (made in the liver) to secondary bile acids in the gut.

In this industry-sponsored post-hoc analysis of an open-label study of VOWST received by 263 patients (77 with a first recurrence of CDI [frCDI] and 186 with multiply-rec…

Reviewing Author

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Can Oral Microbiome Therapy Break the Cycle of Recurrent Clostridioides difficile Infection?

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Reviewing Author