Recurrent Clostridioides difficile Infection: Current Clinical Management and Microbiome-Based Therapies

Berry, Parul; Khanna, Sahil

doi:10.1007/s40259-023-00617-2

Cited by 5 publications

(3 citation statements)

References 148 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The transplant material is prepared from a donor stool from two sources: current patients and universal donors from a stool bank (Edelstein et al, 2016 ). The major drawback in the use of FMT for recurrent CDI is the lack of standardization regarding the preparation process and administration techniques (Berry and Khanna, 2023 ). In addition, patients who have completed antibiotic therapy for recurrent CDI and who are 18 years and older can receive Rebyota as a prophylactic biotherapeutic treatment (Berry and Khanna, 2023 ).…”

Section: Discussionmentioning

confidence: 99%

“…The major drawback in the use of FMT for recurrent CDI is the lack of standardization regarding the preparation process and administration techniques (Berry and Khanna, 2023 ). In addition, patients who have completed antibiotic therapy for recurrent CDI and who are 18 years and older can receive Rebyota as a prophylactic biotherapeutic treatment (Berry and Khanna, 2023 ). It should be taken rectally and needs to be administered only once (Kim et al, 2023 ).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Alternative treatment of recurrent Clostridioides difficile infection in adults by fecal transplantation: an overview of phase I–IV studies from Clinicaltrials.gov

Obaid

2024

Front. Microbiol.

View full text Add to dashboard Cite

BackgroundFecal microbiota transplantation (FMT) is an interventional approach to treat chronic and recurrent Clostridioides difficile infection (CDI). However, there is insufficient evidence regarding its effectiveness and safety. Clinical trials have been conducted to inspect the safety and effectiveness of FMT with and without comparison to pharmacological treatments.AimThis review explored the treatment of CDI in adults using FMT and evaluated the safety of this intervention based on phase I–IV studies registered on Clinicaltrials.gov.MethodA comprehensive search of Clinicaltrials.gov was conducted to identify relevant studies that investigated CDI in adults. Data on study type, study design, sample size, intervention details, and outcomes related to FMT were examined and evaluated.ResultsIn total, 13 clinical trials on FMT for CDI published through 17 November 2023 were identified, all of which were interventional studies. The investigation focused on both terminated and completed studies. Basic and advanced outcome measures were examined.ConclusionSome studies were terminated during phase II, and FMT was less effective than antibiotics such as vancomycin and fidaxomicin. However, colonoscopy and oral FMT were explored in several completed studies with promising results, but the evidence remains limited and inconclusive.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Alternative treatment of recurrent Clostridioides difficile infection in adults by fecal transplantation: an overview of phase I–IV studies from Clinicaltrials.gov

Obaid

2024

Front. Microbiol.

View full text Add to dashboard Cite

show abstract

“…8,71 For this reason, microbiota restoration therapy (MRT) or FMT are potentially valuable options for the treatment of rCDI. 72,73 Multiple standardized microbiome-based therapies have been studied for the prevention of rCDI in populations that did not include immunosuppressed patients (reviewed 74 ), and various case reports and retrospective studies have been published reporting good outcomes using FMT in HCT and immunosuppressed patients. [75][76][77][78] The first case report of FMT performed on an allo-HCT recipient was published by Neemann et al in 2012 75 for the treatment of fulminant CDI with a successful outcome.…”

Section: Fecal Microbiota Transplantationmentioning

confidence: 99%

Clostridioides difficile infection in the allogeneic hematopoietic cell transplant recipient

Lo Porto,

Mularoni,

Castagnola

et al. 2023

Transplant Infectious Dis

View full text Add to dashboard Cite

Clostridioides difficile (CD) is one of the most important causes of diarrhea in hospitalized patients, in particular those who undergo an allogeneic hematopoietic cell transplant (allo‐HCT) and who are more at risk of developing a CD infection (CDI) due to frequent hospitalizations, iatrogenic immunosuppression, and prolonged antibiotic cycles. CDI may represent a severe condition in allo‐HCT patients, increasing the length of hospitalization, influencing the intestinal microbiome with a bidirectional association with graft‐versus‐host disease, and leading to unfavorable outcomes, including death. The diagnosis of CDI requires the exclusion of other probable causes of diarrhea in HCT patients and is based on highly sensitive and highly specific tests to distinguish colonization from infection. In adult patients, fidaxomicin is recommended as first‐line, with oral vancomycin as an alternative agent. Bezlotoxumab may be used to reduce the risk of recurrence. In pediatric patients, vancomycin and metronidazole are still suggested as first‐line therapy, but fidaxomicin will probably become standard in pediatrics in the near future. Because of insufficient safety data, fecal microbiota transplantation is not routinely recommended in HCT in spite of promising results for the management of recurrences in other populations. image

show abstract

The Progression of Microbiome Therapeutics for the Management of Gastrointestinal Diseases and Beyond

Allegretti,

Khanna,

Mullish

et al. 2024

Gastroenterology

View full text Add to dashboard Cite

Recurrent Clostridioides difficile Infection: Current Clinical Management and Microbiome-Based Therapies

Cited by 5 publications

References 148 publications

Alternative treatment of recurrent Clostridioides difficile infection in adults by fecal transplantation: an overview of phase I–IV studies from Clinicaltrials.gov

Alternative treatment of recurrent Clostridioides difficile infection in adults by fecal transplantation: an overview of phase I–IV studies from Clinicaltrials.gov

Clostridioides difficile infection in the allogeneic hematopoietic cell transplant recipient

The Progression of Microbiome Therapeutics for the Management of Gastrointestinal Diseases and Beyond

Contact Info

Product

Resources

About