Rates of C. diff in the UK have increased every year since 2021, reaching 29.5 cases per 100,000 population in England in 2023/2024.
The bacterial infection causes gastrointestinal illness, ranging from diarrhoea and abdominal pain to sepsis.
Now, a trial in the United States which involved treating patients with ibezapolstat has provided high rates of “sustained” clinical cures, according to scientists.
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As the effectiveness of antibiotics meant to fight Clostridioides difficile, or C. diff, wanes, researchers at the University of Houston saw positive results when testing the antibiotic.
Until now the frontline treatments for C. diff have been the antibiotics vancomycin, with a sustained clinical cure of 42% to 71%, and fidaxomicin at 67%.
But doctors say a superbug would not be so deadly if it was not able to outlive the very medicines meant to destroy it.
Study senior author Professor Kevin Garey said: “Both vanco and fidaxo are associated with emerging antimicrobial resistance. C. difficile infection recurrence is associated with increased mortality, decreased quality of life and higher healthcare costs.
“New antibiotics are urgently needed.”
He says C. diff infections often return when the natural balance in the gut stays disrupted – good bacteria such as Bacillota, Bacteroidota, and Actinomycetota are reduced, while harmful types like Pseudomonadota increase.
Prof Garey says such changes can weaken the gut’s defences, causing a loss of the kind of bacteria that helps break down bile acids.
When that happens, harmful bacteria can easily take over.
Study lead author Dr Taryn Eubank said: “Ibezapolstat’s mechanism of action helps restore the healthy microbiota that causes C. diff recurrence.”
The findings, published in The Lancet Microbe, show ibezapolstat has a way of working that kills harmful C. diff bacteria without harming the good bacteria in the gut that protect against C. diff infections.
The study was conducted at 15 centres, primarily outpatient clinics and hospitals in the United States.
Participants were aged 18 to 90 with diarrhoea and a confirmed diagnosis of mild or moderate C diff infection.
