Clostridioides difficile infection (CDI) (recurrent) & Drugs/Treatments

Recurrent infections require different therapy from the initial antibiotic.
Berry & Khanna 2023 BioDrugs 37(6): 757-773

Considerable progress has been made in the development of new anti-CDI drug candidates. Nevertheless, a greater comprehension of Clostridioides difficile infection (CDI) pathogenesis and host-microbe interactions is beginning to uncover potential novel therapeutic targets, which can be exploited to plug gaps in the Clostridioides difficile infection (CDI)(brain://bQ4LAx9Ly0u1JoYHsdVoaQ/ClostridioidesDifficileInfectionCdi) drug discovery pipeline.
Monaghan et al. 2021 Expert Opinion on Therapeutic Targets 25(11): 949-963

Add-on treatment with Fructooligosaccharides (FOS), NTCD-M3 spores, Rifaximin, RBX2660, and Bezlotoxumab were associated with lower incidence of Clostridioides difficile infection (CDI) (recurrent) than placebo. Evidence on probiotics and SER-109 are uncertain, thus adequately powered trials are warranted
Paschos et al. 2021 Anaerobe 71: 102441

Narrow-spectrum antibiotics have shown improved efficacy, but fecal microbiota transplant (FMT) is highly effective in preventing rCDI.
Louie et al. 2011 N Engl J Med 364: 422-431
Cornely et al. 2012 Lancet Infect Dis 12: 281-289
Kelly et al. 2016 Ann Intern Med 165: 609-616
Baunwall et al. 2020 EClinicalmedicine 29–30: 100642

Metronidazole and vancomycin remain the first-line treatment for multiply recurrent C difficile infection, which might recur despite multiple and prolonged courses of antibiotics
Allegretti et al. 2019 Lancet 394: 420-31

Antibiotics alter the gut microbiota, creating an environment conducive to the germination of Clostridioides (Clostridium) difficile spores and the pathogen's spread. The Clostridioides (Clostridium) difficile toxins cause, among other things, colitis. Antibiotics directed against C. difficile can reduce exposure to the pathogen and toxin production. Achieving colonization resistance in the gut microbiota can cure Clostridioides difficile infection (CDI). If this is not successful, the patients have a recurrent CDI. In some instances, repeated anti-C difficile antibiotic therapies can eradicate the pathogen. In other cases, therapeutic restoration of a diverse microbiota by FMT is required to overcome CDI.
Leong & Zelenitsky 2013 Can J Hosp Pharm. 66(6): 361-8
Britton & Young 2014

see also:
Fecal Microbiota Transplantation (FMT) & Clostridioides difficile infection (CDI) (recurrent)
Fecal Microbiota Transplantation (FMT) & Clostridioides difficile infection (CDI) In IBD Patients
Fecal Microbiota Transplantation (FMT) + Vancomycin & Clostridioides difficile infection (CDI) (recurrent)
Fidaxomicin & Clostridioides difficile infection (CDI) (recurrent)
CP101 & Clostridioides difficile infection (CDI) (recurrent)
Metronidazole & Clostridioides difficile infection (CDI) (recurrent)
NTCD-M3 spores
Vancomycin & Clostridioides difficile infection (CDI)