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Microbiome Therapeutics and Recurrent Clostridioides difficile: Where Do We Go From Here?

  1. In a randomized, placebo-controlled phase 3 trial of RBX2660 for the treatment of recurrent CDI, what was the rate of treatment success at 8 weeks post-treatment?
  2. In a randomized, placebo-controlled phase 3 trial of SER-109 for the treatment of recurrent CDI, what was the overall rate of recurrence in patients treated with SER-109 through week 8?
  3. Disruption of the healthy gut microbiota (dysbiosis) can result in disease-causing C difficile infection through which of the following mechanisms?
    Colonization of C difficile in the gut
    Increased cholesterol production
    Reduction of secondary bile acids
    Increased production of primary bile acids
  4. A 60-year-old woman presents with a 3-day history of watery diarrhea, abdominal pain, and fever. Two months prior, she presented with similar symptoms. A polymerase chain reaction (PCR) assay was positive for C difficile, and she was treated with oral vancomycin 125 mg 4 times daily for 10 days. This was her first episode of C difficile infection. You perform another PCR assay, which again comes back positive for C difficile
    Based on clinical guidelines issued by the American College of Gastroenterology (ACG), what would be the most appropriate treatment for this patient?
    Fidaxomicin 200 mg orally twice daily for 10 days
    A second course of vancomycin 125 mg orally 4 times daily for 10 day
    Oral vancomycin in a taper and pulse regimen
    Fecal microbiota transplantation