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Treating C. diff: new purpose for an old drug?

Sep. 24, 2019, 10:00 AM

by Paul Govern

Common in hospitals and nursing homes, Clostridioides difficile infection (CDI) is a major health threat, particularly for older patients. According to a 2015 study by the Centers for Disease Control and Prevention, in the U.S. the infection claims some 15,000 lives per year. Certain antibiotics, by disrupting normal gut microorganisms (microbiota), create an opening for the infection.

Developed in the early 1970s, misoprostol is an inexpensive generic drug once used to prevent gastrointestinal ulcers in people taking daily NSAIDs — that is, aspirin, ibuprofen, etc. — but it has since been replaced for that purpose by newer alternatives.

Based partly on the detrimental impact of NSAIDs during CDI, David Aronoff, MD, reasoned that misoprostol may have promise as a treatment for severe CDI.

In a study in the journal Anaerobe, Aronoff and colleagues show that misoprostol protects mice against severe CDI and promotes the recovery of mouse gut microbiota following antibiotic perturbation. With misoprostol, survival from severe CDI increased three-fold.

Aronoff was joined in the study by colleagues at the University of Pennsylvania and by Vanderbilt University Medical Center colleagues Leslie Kirk, Bruno Trindade, PhD, and Eric Skaar, PhD. The study was supported by grants from the National Institutes of Health (TR001723, AI121796, DK058404). Clostridioides difficile was formerly called Clostridium difficile.

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