Vowst’s FDA approval is a boon for the prevention of recurrent Clostridioides difficile infection

Dear Editor,Clostridioides difficile (C.difficile) is an anaerobic, Grampositive, spore-forming bacteria frequently found in the intestines of both humans and animals, leading to Clostridioides difficile infection (CDI) [1,2] .The global prevalence of C. difficile in food samples ranges from 4.8 to 8.2%, with the highest prevalence in seafood [3] .The clinical picture of signs and symptoms vary from asymptomatic to severe fulminant colitis, toxic megacolon, intestinal perforation, and multiple organ dysfunction syndrome [1,2] .The diagnosis is mainly based on clinical presentation and laboratory investigations to detect C. difficile and toxins in feces [4] .Various treatment and preventive options such as actoxumab, bezlotoxumab, surotomycin, cadazolid, and Cdiffense have been used for reducing CDI burden.Despite global efforts to decrease the burden in the past decade, recent studies have reported an increasing global burden of CDI, with a median incidence of ~4 per 10 000 patient days [5] .Approximately 10-20% of the CDI cases are due to recurrent CDI (rCDI), defined as an episode of CDI occurring within 8 weeks following the earlier episode [5,6] .Factors such as advancing age, antibiotic use, malignancy, heart disease, leukocyte count, length of hospital stay, intensive care unit admission, and antiulcer medications are significantly related to rCDI [5,7,8] .In the USA, rCDI is a significant public health challenge, accounting for ~75 000-175 000 cases annually [5,7] .