title: Probiotics as adjunctive therapy for preventing Clostridium difficile infection - What are we waiting for?
abstract: With the end of the golden era of antibiotic discovery, the emergence of a new post-antibiotic age threatens to thrust global health and modern medicine back to the pre-antibiotic era. Antibiotic overuse has resulted in the natural evolution and selection of multi-drug resistant bacteria. One major public health threat, Clostridium difficile, is now the single leading cause of hospital-acquired bacterial infections and is by far the most deadly enteric pathogen for the U.S.
  
  
  METHODS
  Due to the high morbidity and mortality and increasing incidence that coincides with antibiotic use, non-traditional therapeutics are ideal alternatives to current treatment methods and also provide an avenue towards prevention. Despite the need for alternative therapies to antibiotics and the safety of most probiotics on the market, researchers are inundated with regulatory issues that hinder the translational science required to push these therapies forward. This review discusses the regulatory challenges of probiotic research, expert opinion regarding the application of probiotics to C. difficile infection and the efficacy of probiotics in preventing this disease.
authors.affiliation: Texas Children's Microbiome Center, Department of Pathology, Texas Children's Hospital, 1102 Bates Ave., Houston, TX, USA; Department of Pathology & Immunology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, USA. Electronic address: spinler@bcm.edu.
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Spinler
authors.affiliation: Texas Children's Microbiome Center, Department of Pathology, Texas Children's Hospital, 1102 Bates Ave., Houston, TX, USA; Department of Pathology & Immunology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, USA.
authors.forename: Caná L
authors.initials: CL
authors.lastname: Ross
authors.affiliation: Texas Children's Microbiome Center, Department of Pathology, Texas Children's Hospital, 1102 Bates Ave., Houston, TX, USA; Department of Pathology & Immunology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, USA.
authors.forename: Tor C
authors.initials: TC
authors.lastname: Savidge
mesh_terms: D000818:Animals; D002986:Clinical Trials as Topic; D016360:Clostridioides difficile / Q000502:physiology*; D004761:Enterocolitis, Pseudomembranous / Q000517:prevention & control*; D000069467:Fecal Microbiota Transplantation; D000069196:Gastrointestinal Microbiome; D006801:Humans; D019936:Probiotics / Q000627:therapeutic use*
keywords: Bio-K+; Clostridium difficile; Fecal microbiota transplantation; Lactobacillus; Lifeway kefir; Probiotic