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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Clin+Gastroenterol
2016 ; 50
(8
): 624-30
Nephropedia Template TP
gab.com Text
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Twit Text #
English Wikipedia
Ursodeoxycholic Acid Inhibits Clostridium difficile Spore Germination and
Vegetative Growth, and Prevents the Recurrence of Ileal Pouchitis Associated With
the Infection
#MMPMID26485102
Weingarden AR
; Chen C
; Zhang N
; Graiziger CT
; Dosa PI
; Steer CJ
; Shaughnessy MK
; Johnson JR
; Sadowsky MJ
; Khoruts A
J Clin Gastroenterol
2016[Sep]; 50
(8
): 624-30
PMID26485102
show ga
GOALS: To test whether ursodeoxycholic acid (UDCA) is inhibitory to Clostridium
difficile and can be used in the treatment of C. difficile-associated ileal
pouchitis. BACKGROUND: The restoration of secondary bile metabolism may be the
key mechanism for fecal microbiota transplantation (FMT) in treating recurrent C.
difficile infections (RCDI). Therefore, it is possible that exogenous
administration of inhibitory bile acids may be used directly as nonantibiotic
therapeutics for this indication. The need for such a treatment alternative is
especially significant in patients with refractory C. difficile-associated
pouchitis, where the efficacy of FMT may be limited. STUDY: We measured the
ability of UDCA to suppress the germination and the vegetative growth of 11
clinical isolate strains of C. difficile from patients treated with FMT for RCDI.
In addition, we used oral UDCA to treat a patient with RCDI pouchitis that proved
refractory to multiple antibiotic treatments and FMT. RESULTS: UDCA was found to
be inhibitory to the germination and the vegetative growth of all C. difficile
strains tested. Fecal concentrations of UDCA from the patient with RCDI pouchitis
exceeded levels necessary to inhibit the germination and the growth of C.
difficile in vitro. The patient has remained infection free for over 10 months
after the initiation of UDCA. CONCLUSIONS: UDCA can be considered as a
therapeutic option in patients with C. difficile-associated pouchitis. Further
studies need to be conducted to define the optimal dose and duration of such a
treatment. In addition, bile acid derivatives inhibitory to C. difficile that are
able to achieve high intracolonic concentrations may be developed as therapeutics
for RCDI colitis.