Gut Microbiota and New Microbiome-Targeted Drugs for Clostridioides difficile Infections

Abstract

Clostridioides difficile is a major causative pathogen for antibiotic-associated diarrhea and C. difficile infections (CDIs) may lead to life-threatening diseases in clinical settings. Most of the risk factors for the incidence of CDIs, i.e., antibiotic use, treatment by proton pump inhibitors, old age, and hospitalization, are associated with dysbiosis of gut microbiota and associated metabolites and, consequently, treatment options for CDIs include normalizing the composition of the intestinal microbiome. In this review, with an introduction to the CDI and its global epidemiology, CDI-associated traits of the gut microbiome and its metabolites were reviewed, and microbiome-targeting treatment options were introduced, which was approved recently as a new drug by the United States Food and Drug Administration (U.S. FDA), rather than a medical practice.

Keywords: Clostridioides diffcile; Clostridioides diffcile infections; gut microbiota dysbiosis; microbiota-based therapeutics.

Figure 1

Schematic presentation of the 146 clinical trials to develop therapeutic options for CDI. Analyzed the data from http://www.ClinicalTrials.gov, accessed on 4 September 2023. (A) The year of starting the clinical study by category of the therapeutic interventions, (B) continent-based locations running the clinical study (multiple choice was made if the study was conducted in multiple continents), (C) sponsor types of the clinical trials by category of the therapeutic interventions. A total of 146 clinical trials targeting CDI started before 4 September 2023, extracted from ClinicalTrials.gov, were analyzed. SM drug, small molecule drug; FMT, fecal microbial transplantation; diet supp., diet supplement; U. S. Fed., The United States Federal; NIH, National Institute of Health; NA, not available to accept the data.