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Updated: Aug 5, 2026
07:06
Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
Published on: December 8, 2014
Food and Drug Administration-Approved Fecal Microbiota-Based Therapies for Recurrent Clostridioides difficile
Parul Berry1, Jessica R Allegretti2, Sahil Khanna3
1Department of Internal Medicine, Mayo Clinic, 200 1st Avenue SW, Rochester, MN 55905, USA.
Gastroenterology Clinics of North America
|July 31, 2026
Summary
Fecal microbiota-based therapies like Rebyota and Vowst effectively prevent recurrent Clostridioides difficile infection after antibiotics. These FDA-approved treatments restore gut bacteria to reduce infection rates in adults.
Area of Science:
- Microbiology
- Gastroenterology
- Infectious Diseases
Background:
- Recurrent Clostridioides difficile infection (rCDI) is a significant clinical challenge.
- Standard antibiotic treatments often fail to prevent CDI recurrence.
- Optimized antibiotic strategies still leave a need for effective rCDI prevention.
Purpose of the Study:
- To review the clinical development of two FDA-approved fecal microbiota-based therapies for rCDI.
- To summarize evidence supporting fecal microbiota, live-jslm (Rebyota) and fecal microbiota spores, live-brpk (Vowst).
- To discuss practical aspects of implementing these novel therapies.
Main Methods:
- Review of pivotal randomized controlled trials and open-label extensions.
- Analysis of durability data and safety outcomes.
- Inclusion of emerging real-world evidence and implementation considerations.
Main Results:
- Both Rebyota and Vowst demonstrated efficacy in reducing CDI recurrence post-antibiotic treatment.
- Durability and safety data support the long-term use of these therapies.
- Real-world evidence is beginning to corroborate clinical trial findings.
Conclusions:
- Fecal microbiota-based products offer a standardized, evidence-based approach to prevent rCDI.
- These therapies restore colonization resistance, crucial for preventing recurrent infections.
- Appropriate patient selection and implementation are key to successful outcomes.
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