Use of ribaxamase (SYN-004), a β-lactamase, to prevent Clostridium difficile infection in β-lactam-treated patients: a double-blind, phase 2b, randomised placebo-controlled trial

Kokai‐Kun, John F.; Roberts, Tracey; Coughlin, Olivia; Le, Chenxiong; Whalen, Heidi; Stevenson, R. W.; Wacher, Vincent J.; Sliman, Joseph

doi:10.1016/s1473-3099(18)30731-x

Cited by 63 publications

(64 citation statements)

References 26 publications

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“…One-promising way to protect the gut microbiota is to develop molecules to chelate or degrade unexpected residual antibiotics in the colon, thus limiting their impact on gut microbiota. For example, ribaxamase (an orally administered beta-lactamase) and DAV-132 (delivering delivers a non-specific adsorbent which irreversibly captures antibiotics) are currently under development [126,127] (Figure 1). Microorganisms 2020, 8, 269 8 of 16…”

Section: Strategy To Prevent the Occurrence Of Dysbiosismentioning

confidence: 99%

Gut Microbiota, Antibiotic Therapy and Antimicrobial Resistance: A Narrative Review

2020

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Antimicrobial resistance is a major concern. Epidemiological studies have demonstrated direct relationships between antibiotic consumption and emergence/dissemination of resistant strains. Within the last decade, authors confounded spectrum activity and ecological effects and did not take into account several other factors playing important roles, such as impact on anaerobic flora, biliary elimination and sub-inhibitory concentration. The ecological impact of antibiotics on the gut microbiota by direct or indirect mechanisms reflects the breaking of the resistance barrier to colonization. To limit the impact of antibiotic therapy on gut microbiota, consideration of the spectrum of activity and route of elimination must be integrated into the decision. Various strategies to prevent (antimicrobial stewardship, action on residual antibiotics at colonic level) or cure dysbiosis (prebiotic, probiotic and fecal microbiota transplantation) have been introduced or are currently being developed.

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Section: Strategy To Prevent the Occurrence Of Dysbiosismentioning

confidence: 99%

Gut Microbiota, Antibiotic Therapy and Antimicrobial Resistance: A Narrative Review

2020

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“…There is also an oral b-lactamase (SYN-004) being studied that is supposed to protect the colonic microbiota by reducing the antibiotic concentration in the intestinal lumen. SYN-004 -ribaxamase is an oral b-lactamase that has been designed for administration together with intravenous b-lactam antibiotics [78].…”

Section: Discussionmentioning

confidence: 99%

Guidelines for Clostridium difficile infection in adults

Kukla

Adrych

Dobrowolska

et al. 2020

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Clostridium difficile infection (CDI) has become a serious medical and epidemiological problem, especially in well developed countries. There has been evident increase in incidence and severity of CDI. Prevention, proper diagnosis and effective treatment are necessary to reduce the risk for the patients, deplete the spreading of infection and diminish the probability of recurrent infection. Antibiotics are the fundamental treatment of CDI. In patients who had recurrent CDI fecal microbiota transplantation seems to be promising and efficient strategy. These guidelines systematize existing data and include recent changes implemented in the management of CDI. Guidelines for Clostridium difficile infection in adults

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“…128 New studies are needed to assess the clinical and microbial impact of specific antibiotic molecules and new microbiome-sparing antibiotic strategies. A novel approach to protect the microbiome from antibiotic-mediated dysbiosis could be the use of beta-lactamase enzymes to degrade residual antibiotics in the gastrointestinal tract before the flora is harmed, 129 or preventing the local action of antibiotic residuals at the colonic level by sequestering them, while leaving their small intestine absorption intact. 130,131 Nutritional strategies, either by changing the route of nutritional supplementation or by the administration of specific molecules, are also promising cost-and risk-effective methods of modulating the gut microbiome.…”

Section: Conclusion and Future Strategiesmentioning

confidence: 99%

Insights into the role of intestinal microbiota in hematopoietic stem-cell transplantation

Zama

Bossù

Leardini

et al. 2020

Therapeutic Advances in Hematology

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The gut microbiota (GM) is able to modulate the human immune system. The development of novel investigation methods has provided better characterization of the GM, increasing our knowledge of the role of GM in the context of hematopoietic stem-cell transplantation (HSCT). In particular, the GM influences the development of the major complications seen after HSCT, having an impact on overall survival. In fact, this evidence highlights the possible therapeutic implications of modulation of the GM during HSCT. Insights into the complex mechanisms and functions of the GM are essential for the rational design of these therapeutics. To date, preemptive and curative approaches have been tested. The current state of understanding of the impact of the GM on HSCT, and therapies targeting the GM balance is reviewed herein.

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Use of ribaxamase (SYN-004), a β-lactamase, to prevent Clostridium difficile infection in β-lactam-treated patients: a double-blind, phase 2b, randomised placebo-controlled trial

Cited by 63 publications

References 26 publications

Gut Microbiota, Antibiotic Therapy and Antimicrobial Resistance: A Narrative Review

Gut Microbiota, Antibiotic Therapy and Antimicrobial Resistance: A Narrative Review

Guidelines for Clostridium difficile infection in adults

Insights into the role of intestinal microbiota in hematopoietic stem-cell transplantation

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