Improving Quality of Life For Those With Recurrent C Difficile

One in 6 patients with Clostridioides difficile infection (CDI) will experience a recurrence of it within 2-8 weeks after treatment.¹ For people who have suffered through recurrent bouts of C difficile, quality of life can be greatly diminished. Recurrent CDI (rCDI) results in a markedly reduced health-related quality of life (HRQoL) as patients face declining health, isolation, hospitalizations, or possibly death, write Khanna et al.¹

“The patients are worried. Is this going to come back? How quickly is it going to come back? Am I going to be out socially and have an episode where I have to run to the bathroom,” Paul Feuerstadt, MD, FACG, AGAF, associate clinical professor of Medicine at Yale School of Medicine, said. “So there's fear; there's anxiety there's nightmares; I basically say there's post-traumatic stress disorder, associated with this.”

Traditionally, antibiotics have been used to treat recurring bouts of C difficile. However, in recent years, there are alternatives to antibiotics including a treatment, Fecal microbiota, live-jslm (Rebyota [RBL]), which is indicated for treatment of recurrent C difficile. It has been FDA approved for over 2 years now.

RBL manufacturer, Ferring Pharmaceuticals, conducted a questionnaire with RBL participants looking at their quality-of-life. The survey questions were comprised of issues around mental, physical, and social aspects of patients’ lives.

The survey results showed that those patients who responded to RBL treatment were more likely to report improved HRQOL than placebo responders.²
“Improvements in HRQOL mental domain scores were associated with changes in microbiome and metabolome composition — a larger improvement in mental HRQOL was associated with: 1) increased relative abundance of Clostridia and Bacteroidia; 2) decreased Gammaproteobacteria and Bacilli; and 3) predominance of secondary rather than primary bile acids,” investigators wrote.²

Feuerstadt has been a trial investigator for RBL and has been using the treatment in his practice for years so he knows first hand patients’ stories and enjoys seeing the benefits of successful treatment.

“You're A, treating the bug, but B, you're actually treating their health-related quality of life, their mental and their physical and their social ability to lead their lives, and that's incredibly powerful,” Feuerstadt said.

References
1. Improved Symptoms and Health-Related Quality of Life in Adults with Recurrent Clostridioides Difficile Infection after Fecal Microbiota, Live-jslm (RBL) Administration by Colonoscopy. Abstract presented at DDW 2025 , May 3-6, 2025. Accessed June 26, 2025.
2. Health-Related Quality of Life is Correlated With Microbiome and Metabolom Compositions During Treatment For Prevention of Recurrent Clostridioides difficile Infection: Exploratory Analysis of a Phase 3 Study of Fecal Microbiota,LIVE-JSLM. Abstract presented at DDW 2025 , May 3-6, 2025. Accessed June 26, 2025.