Clostridioides difficile infection, which is more common among patients in healthcare settings, causes diarrhea and inflammation of the colon. While anyone can get infected by this bacterium, the risk is highest for people who are currently taking antibiotics or have recently completed a course. In fact, individuals are up to 10 times more likely to develop a C. diff infection during or within three months after antibiotic use, and longer antibiotic courses can double that risk, according to the Centers for Disease Control and Prevention.
The current first-line treatments for Clostridioides difficile infection, including vancomycin and fidaxomicin, are effective at achieving a high initial cure rate. However, these antibiotics can disrupt the gut microbiome (dysbiosis), which contributes to high recurrence rates of 20-40%. In addition, the use of antibiotics is linked to the broader public health concern of antimicrobial resistance (AMR). In the U.S., there are two microbiome-based therapies approved for recurrent C. difficile infection - VOWST (oral) and Rebiotix (rectal). Both are approved for use only after patients have received standard first-line antibiotics.
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