Clostridium difficile infection (CDI) causes a great deal of suffering in the elderly and now more frequently in the general population. CDI can occur after treatment with broad-spectrum antibiotics. Infections with this microbes causes severe gastrointestinal distress, including bloating and gas. Left untreated, and even when treated, it can be fatal. When treated with conventional antibiotics, there is often recurrence, which is understandable, since antibiotics often cause the problem in the first place. There have been two important advancements in the last few years that are leading to effective treatments against this scourge.
First, Kelly et al. demonstrate the successful cure of patients suffering from a 3rd recurrence of the CDI by a fecal transplant. Fecal material from a healthy donor was delivered by colonoscopy to infected individuals and 90% were cured of the infection.
Second, Professor Kim Janda's research group has discovered that Clostridium difficile is sensitive to several classes of anti-worm drugs, called salicylanilides. Dr. Janda has his own bout of CDI and contracting the infection, and his difficulties with it, gave him a strong incentive to find a better treatment. He assigned his research assistant, Major Gootiyto to look new treatments for CDI. In his hunt, Gootiyti was using a salicylanilide called closantel as a negative control. This is a deworming drug used in cattle, sheep, and goats. The target worms are eukaryotes, so it was surprising to find it effective against the CDI bacterium. Gootiyti went on to synthesize other salicylanilides compounds that were even more effective against CDI and the candidate drug has now been turned over to a pharmaceutical firm for scale up.
With these two treatments, it may become possible to control most CDI infections quickly.