Effect of Clostridium butyricum and antibiotics using simultaneous simple suspension in mice with Clostridioides difficile infection

A simple suspension method, wherein tablets and capsules are disintegrated in warm water (55 °C), is increasingly used in clinical settings. Previously, we demonstrated that probiotic strains were reduced or below limit of detection in a simultaneous simple suspension of probiotic preparations and metronidazole or fidaxomicin. This study investigated its effectiveness in mice with C. difficile infection (CDI). Clostridium butyricum products and antibiotics used in this study were the Miya-BM tablet (CBM), metronidazole (Flagyl 250-mg oral tablet), and fidaxomicin (Dafclir 200-mg tablet). Non-infected mice received a simple suspension of CBM and antibiotics simultaneously to assess probiotic viability in the feces. Additionally, C. difficile counts and cytokine production were investigated in CDI-infected mice treated with these suspensions. C. butyricum was detectable in the feces of non-infected mice receiving simultaneous suspensions of CBM and antibiotics. In CDI-infected mice, simultaneous suspensions significantly reduced C. difficile colony counts in feces compared to CBM or antibiotics alone. Furthermore, suspensions downregulated tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and IL-10 levels, while upregulating interferon-γ (IFN-γ) levels in colon tissues, indicating reduced inflammation and an enhanced immune response. This study using mice demonstrates the effectiveness of simultaneous simple suspensions of CBM and antibiotics in treating CDI. This approach significantly reduces C. difficile counts, modulates cytokine levels, and maintains probiotic viability, potentially making it a viable option for administration via gastric tubes in clinical settings.