20.500.12556/DiRROS-21242 New treatment approaches for Clostridioides difficile infections alternatives to antibiotics and fecal microbiota transplantation New treatment approaches for Clostridioides difficile infections: alternatives to antibiotics and fecal microbiota transplantation Clostridioides difficile causes a range of debilitating intestinal symptoms that may be fatal. It is particularly problematic as a hospital-acquired infection, causing significant costs to the health care system. Antibiotics, such as vancomycin and fidaxomicin, are still the drugs of choice for C. difficile infections, but their effectiveness is limited, and microbial interventions are emerging as a new treatment option. This paper focuses on alternative treatment approaches, which are currently in various stages of development and can be divided into four therapeutic strategies. Direct killing of C. difficile (i) includes beside established antibiotics, less studied bacteriophages, and their derivatives, such as endolysins and tailocins. Restoration of microbiota composition and function (ii) is achieved with fecal microbiota transplantation, which has recently been approved, with standardized defined microbial mixtures, and with probiotics, which have been administered with moderate success. Prevention of deleterious effects of antibiotics on microbiota is achieved with agents for the neutralization of antibiotics that act in the gut and are nearing regulatory approval. Neutralization of C. difficile toxins (iii) which are crucial virulence factors is achieved with antibodies/antibody fragments or alternative binding proteins. Of these, the monoclonal antibody bezlotoxumab is already in clinical use. Immunomodulation (iv) can help eliminate or prevent C. difficile infection by interfering with cytokine signaling. Small-molecule agents without bacteriolytic activity are usually selected by drug repurposing and can act via a variety of mechanisms. The multiple treatment options described in this article provide optimism for the future treatment of C. difficile infection. microbiota immunomodulators mikrobiota imunomodulacija true false true Taylor & Francis Velika Britanija Angleški jezik Slovenski jezik © 2024 The Author(s). Neznano 2025-01-17 13:21:46 2025-01-17 13:21:46 2025-01-18 03:38:13 0000-00-00 00:00:00 2024 0 0 Nasl. z nasl. zasl.; Soavtorji: Abida Zahirović, Maruša Bizjak, Maja Rupnik, Borut Štrukelj, Aleš Berlec; Opis vira z dne 11. 4. 2024; str. 1-34 iss. 1 Vol. 16 2024 0000-00-00 Zaloznikova Objavljeno apc 2024-01-29 2024-03-27 2024-04-09 615 1949-0984 10.1080/19490976.2024.2337312 192145923 https://www.tandfonline.com/doi/full/10.1080/19490976.2024.2337312 1 9f1c20a4-d4cd-11ef-ba3f-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=30147 RAZ_Bratkovic_Tomaz_2024.pdf RAZ_Bratkovic_Tomaz_2024.pdf 1 2BA84E99F7595644E3E5F39545EA78AD 07737e232468954ab2dca158d5fe22a08af3c2934b0070f78d92cee225355843 ee1ffc62-d4ce-11ef-ba3f-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=30148 Institut Jožef Stefan 0 0 0