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Therapeutics/Prevention
Randomised control trial
Non-toxigenic Clostridium difficile to prevent recurrent C. difficile infection
  1. Daniel M Musher,
  2. Hoonmo Koo
  1. Baylor College of Medicine, Houston, Texas, USA
  1. Correspondence to : Dr Daniel M Musher, Department of Infectious Diseases, VA Medical Center, 2002 Holcombe Boulevard, Houston, TX 77030, USA; Daniel.musher{at}va.gov

https://doi.org/10.1136/ebmed-2015-110234

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    Commentary on: Gerding DN, Meyer T, Lee C, et al. Administration of spores of nontoxigenic Clostridium difficile strain M3 for prevention of recurrent C. difficile infection: a randomized clinical trial. JAMA 2015;313:1719–27.OpenUrlCrossRefPubMed

    Context

    Clostridium difficile colitis (CDI) is strongly associated with hospitalisation and antibiotic therapy. As disruption of the colonic biome is responsible for disease, it should not be surprising that antimicrobial therapy, which further perturbs intestinal microbiota, has been such a dismal treatment failure. Treating patients for CDI with metronidazole, oral vancomycin, nitazoxanide or fidaxomycin cures a little over one-half, suppresses the disease followed by relapse in about 30% and fails to bring about a satisfactory response in about 20% of cases.1

    Methods

    Gerding and colleagues wanted to see whether they could successfully colonise the bowel with a non-toxin producing C. difficile (NTPCD) strain and if it could …

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    Footnotes

    • Competing interests None declared.

    • Provenance and peer review Commissioned; internally peer reviewed.