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Updated: Jun 25, 2025
Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
Published on: December 8, 2014
A Comparison of Currently Available and Investigational Fecal Microbiota Transplant Products for Recurrent
Yifan Wang1, Aaron Hunt1, Larry Danziger1,2
1Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Chicago, IL 60612, USA.
Abstract:
Clostridioides difficile infection (CDI) is an intestinal infection that causes morbidity and mortality and places significant burden and cost on the healthcare system, especially in recurrent cases. Antibiotic overuse is well recognized as the leading cause of CDI in high-risk patients, and studies have demonstrated that even short-term antibiotic exposure can cause a large and persistent disturbance to human colonic microbiota. The recovery and sustainability of the gut microbiome after dysbiosis have been associated with fewer CDI recurrences. Fecal microbiota transplantation (FMT) refers to the procedure in which human donor stool is processed and transplanted to a patient with CDI. It has been historically used in patients with pseudomembranous colitis even before the discovery of Clostridioides difficile. More recent research supports the use of FMT as part of the standard therapy of recurrent CDI. This article will be an in-depth review of five microbiome therapeutic products that are either under investigation or currently commercially available: Rebyota (fecal microbiota, live-jslm, formerly RBX2660), Vowst (fecal microbiota spores, live-brpk, formerly SER109), VE303, CP101, and RBX7455. Included in this review is a comparison of the products' composition and dosage forms, available safety and efficacy data, and investigational status.
Insights
Fecal microbiota transplantation (FMT) is a promising treatment for recurrent Clostridioides difficile infection (CDI). This review examines five microbiome therapeutics, including approved and investigational products, for CDI treatment.
Area of Science:
- Microbiome therapeutics
- Gastroenterology
- Infectious diseases
Background:
- Clostridioides difficile infection (CDI) causes significant morbidity, mortality, and healthcare costs, particularly in recurrent cases.
- Antibiotic overuse disrupts the gut microbiota, increasing CDI risk and recurrence.
- Gut microbiome recovery is crucial for preventing CDI recurrence.
Purpose of the Study:
- To review five microbiome therapeutic products for Clostridioides difficile infection (CDI).
- To compare product composition, dosage forms, safety, efficacy, and investigational status.
- To provide an in-depth analysis of emerging treatments for recurrent CDI.
Main Methods:
- Literature review of microbiome therapeutics for CDI.
- Analysis of product composition and dosage forms.
- Evaluation of available safety and efficacy data.
Main Results:
- Five microbiome therapeutic products (Rebyota, Vowst, VE303, CP101, RBX7455) were reviewed.
- Products vary in composition (live bacteria, spores) and dosage forms.
- Safety and efficacy data are emerging for these novel CDI treatments.
Conclusions:
- Fecal microbiota transplantation (FMT) and related microbiome therapeutics represent a significant advancement in recurrent CDI treatment.
- These products offer alternatives to traditional therapies, addressing antibiotic-induced dysbiosis.
- Further research and clinical data are essential to establish the full potential of these microbiome-based interventions.
