Treating Clostridioides difficile: Could Microbiota-based Live Biotherapeutic Products Provide the Answer?

Abstract

Clostridioides difficile infection (CDI) is a pressing health care issue due to the limited effectiveness of current treatments and high recurrence rates. Current available antibiotic options for CDI disrupt the fecal microbiome which predisposes recurrent CDI. Fecal microbiota transplantation (FMT) has improved the outcomes of recurrent CDI, but concerns surrounding the safety and standardization of the product persist. Microbiota-based live biotherapeutic products (LBPs), are emerging as potential alternatives to FMT for CDI treatment. This review explores the potential of LBPs as safe and effective therapy for CDI. While preclinical and early clinical studies have shown promising results, further research is necessary to determine the optimal composition and dosage of LBPs and to ensure their safety and efficacy in clinical practice. Overall, LBPs hold great promise as a novel therapy for CDI and warrant further investigation in other conditions related to disruption of the colonic microbiota.

Keywords:

• Clostridioides difficile
• microbiome
• live biotherapeutic products
• recurrence

Disclosure

Robert Orenstein served as an advisor for Rebiotix/Ferring and Mayo Clinic has received research funding from Rebiotix/Ferring, Finch Therapeutics, and Vedanta. Dr Nagarakanti reports no conflicts of interest in this work.