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Current Infectious Disease Reports
Published in: Current Infectious Disease Reports 8/2020

01-08-2020 | Antibiotic | Antimicrobial Development and Drug Resistance (KC Claeys and J Smith, Section Editors)

Follow your Gut: Microbiome-Based Approaches in the Developmental Pipeline for the Prevention and Adjunctive Treatment of Clostridioides difficile Infection (CDI)

Authors: A. J. Gonzales-Luna, T. J. Carlson

Published in: Current Infectious Disease Reports | Issue 8/2020

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Abstract

Purpose of Review

Antibiotic use is the most important modifiable risk factor for the development of Clostridioides difficile infection (CDI). In addition, up to a quarter of patients treated with standard-of-care antibiotics experience disease recurrence. Until 2016, when bezlotoxumab was approved by the U.S. Food and Drug Administration (FDA), antibiotics were the only medication class approved for use in CDI. A growing knowledge of the roles that the gut microbiome and immune system play in CDI progression and recovery demands new approaches to treatment. As a result, there are many agents, including adjunctive biotherapeutics, nontoxigenic C. difficile competitors, enzymes, and antibiotic binders, used to prevent and treat CDI in the developmental pipeline. The purpose of this focused review is to summarize these unique therapies in all stages of development.

Recent Findings

Here, we discuss 13 agents in development, including four that have completed phase II trials, four in phase II trials, three in phase I trials, and two still undergoing preclinical trials. A number of new approaches including adjunctive biotherapeutics (n = 7), nontoxigenic C. difficile competitors (n = 1), enzymes used to prevent gut dysbiosis (n = 4), and antibiotic binders (n = 1) are discussed here.

Summary

The CDI therapeutic pipeline contains a variety of unique microbiome-based approaches targeting both prevention and adjunctive treatment of CDI. The future of CDI management promises a variety of innovative approaches to better manage this disease state.
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Metadata
Title
Follow your Gut: Microbiome-Based Approaches in the Developmental Pipeline for the Prevention and Adjunctive Treatment of Clostridioides difficile Infection (CDI)
Authors
A. J. Gonzales-Luna
T. J. Carlson
Publication date
01-08-2020
Publisher
Springer US
Published in
Current Infectious Disease Reports / Issue 8/2020
Print ISSN: 1523-3847
Electronic ISSN: 1534-3146
DOI
https://doi.org/10.1007/s11908-020-00729-8
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Keynote webinar | Spotlight on medication adherence

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WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

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