Treatment Updates in Recurrent C Difficile Infections
Paul Feuerstadt, MD, FACG, AGAF, discusses how antibiotics remain the initial treatment for Clostridioides difficile infections, but due to limited efficiency and recurrence rates, newer therapies including fecal microbiota transplantation (FMT), Rebyota (a purified live biotherapeutic), and Vowst (an oral microbiota therapeutic) have emerged as FDA-approved options that restore gut microbiome diversity and show promising efficiency in preventing recurrent infections, particularly in patients who have failed standard antibiotic therapy.
Episodes
November 26th 2024EP. 1: The Role of Testing for C Difficile in Clinical Practice
Paul Feuerstadt, MD, FACG, AGAF, discusses how testing for Clostridioides difficile is recommended for hospitalized patients or outpatients with new-onset, unexplained diarrhea who have risk factors such as recent antibiotic use, hospitalization, or older age, and how empiric treatment should be initiated while awaiting test results if there is high clinical suspension.
November 26th 2024EP. 2: Utilizing Antibiotics in Treatment of C Difficile
The panelist discusses how antibiotics are paradoxically both the primary treatment for Clostridioides difficile infections and a major risk factor for recurrence since they disrupt the protective gut microbiome, which led to the development of alternative therapies like fecal microbiota transplantation to restore microbial balance and prevent reinfection.
December 3rd 2024EP. 3: Examining FMT for Patients With Recurrent C Difficile infections
The panelist discusses how fecal microbiota transplantation (FMT) involves transferring stool from healthy donors to restore gut microbiota in patients with recurrent Clostridioides difficile infection, though safety concerns include potential pathogen transmission and careful donor screening requirements, while OpenBiome’s standardized frozen FMT preparations have helped advance accessibility but should be used according to current FDA guidance for investigational use.
December 3rd 2024EP. 4: Exploring Rebyota for Recurrent C Difficile Infections
The panelist discusses how Rebyota is an FDA-approved microbiome therapeutic that delivers standardized, purified intestinal microbiota through enema administration to restore gut microbial diversity and prevent recurrent Clostridioides difficile infection, differing from conventional fecal microbiota transplantation (FMT) in its regulatory status, standardized manufacturing process, and enhanced safety profile due to extensive screening and purification of donor material.
