Clostridia Difficile Colitis Treatment Pills on the Horizon

Antibiotic related colitis powered by post antibiotic clostridium difficile bacteria infection has become epidemic. Patients suffer from abdominal cramps, fever, recurrent loose and bloody stools. Dehydration and even bowel perforation have occurred. Treatment involves using a non-absorbable antibiotic called vancomycin . If that failed, fidaxomicin has been used in recent years – since its development and approval.

Despite the use of these drugs, patients have been having more frequent recurrences which sometimes require additional treatment. When these treatments fail to stop recurrences, researchers have gone to fecal transplants – tried via collected stool enemas. The idea that an individual suffering from fevers, severe recurrent abdominal pain and diarrhea, sometimes grossly bloody would consent to an enema of collected stool points out just how miserable this entity makes the poor suffering individuals.

At a virtual meeting of the American College of Gastroenterology 2021, Jessica Allegreti, MD, MPH, a gastroenterologist at the Brigham and Women’s Hospital in Boston Massachusetts reported on the most recent successful trial of a freeze-dried human stool pill. The pill contains a powder of freeze-dried human stools from pre-selected donors. The study selected patients who had suffered through several bouts of C Difficile colitis and were now symptom free. The group had either been treated for their last recurrence with vancomycin or fidaxomicin.

After a period of days for the antibiotics to wash out of their system, they were either assigned to receive the CP101 pill or a placebo. Normally these patients would be told to resume their lives and receive no treatment unless they developed symptoms of a C Difficile recurrence. The pill was more successful than the placebo in preventing recurrences at the 24-week mark.

Interestingly, when the stool of all the disease victims was looked at for normal bacteria that is supposed to be present in our bowels, they had a paucity of bacterial types expected. One week after taking the freeze-dried pill the numbers and diversity of healthy bacteria had increased due to the CP101 contents.

The pill is made by Finch Therapeutics and now moves into Phase 3 studies prior to being ready to be presented for marketing. Competing firm Vedanta Biosciences is doing similar studies with its whole stool VE303 pill while Seres Therapeutics works with SER-109 which is an accumulation of highly purified Firmicutes spores.

Having an oral pill to replenish our natural micro biome after an unfortunate antibiotic related colitis infection with C Difficile will be a major advance in its treatment. Hopefully it will reduce the recurrences of this miserable disease.