Deworming Drugs Could Treat Deadly C. Difficile Infection

In the journal Scientific Reports, researchers from The Scripps Research Institute (TSRI) in San Diego, CA, reveal that some forms of the deworming medications salicylanilides stopped the growth of numerous C. difficile strains - even some that cause recurrent infections.

C. difficile is a bacterium that triggers inflammation of the colon, causing symptoms such as diarrhea, fever, loss of appetite, nausea, and abdominal pain.

According to a 2015 study from the Centers for Disease Control and Prevention (CDC), C. difficile is estimated to have caused almost half a million infections in a single year in the United States, and around 29,000 patients died from the infection within 30 days of diagnosis.

For primary C. difficile infection, antibiotic treatment is often the first port of call. But the CDC note that infection returns for around 20 percent of patients, due to the emergence of what are called "hypervirulent" strains.

Making treatment of C. difficile infection even more challenging is that an increasing number of strains are developing antibiotic resistance; the situation has become so serious that the CDC deem C. difficile as an "urgent threat" to public health.

Now, senior author Kim D. Janda - director of the Worm Institute for Research & Medicine (WIRM) and the Ely R. Callaway, Jr. professor of chemistry at TSRI - and team suggest salicylanilides may be a feasible treatment for C. difficile infection.

Salicylanilides halted C. difficile growth

Spurred by his own experience of hard-to-treat C. difficile infection, Janda - alongside first author Major Gooyit, a research associate in Janda's lab - began testing a number of compounds for their effects on C. difficile.

By doing so, they found that a salicylanilide called closantel - used to treat worms in cattle, sheep, and goats - showed some effectiveness in halting growth of the bacterium.

On testing a further three salicylanilides on various lab-cultured C. difficile strains - rafoxanide, niclosamide, and oxyclozanide - they saw the same effect.

These deworming medications even stopped the growth of a C. difficile strain called BI/NAP1/027 - a strain known to be hypervirulent - and they were just as effective as antibiotics currently used to fight this strain, and even more effective in some cases.

Further testing revealed that closantel and rafoxanide were best for halting C. difficile growth, and they even demonstrated some effectiveness against deadly "stationary-phase" C. difficile cells.

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