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Life sciences · Journal article
Gut Microbes · August 27, 2026
A consensus or society position rather than new primary data.
This is a narrative review that conceptualizes microbiome-based CDI therapeutics into three mechanistic categories—additive (FMT, LBPs, consortia), subtractive (targeted antibiotics, bacteriocins, phages, CRISPR), and modulatory (toxin, bile acid, spore germination targeting)—and frames them as a shift from pathogen-centric to ecological therapy. It does not report new clinical trial results or meta-analytic synthesis, but rather organizes existing knowledge to guide future intervention design and research.
Narrative review. Patients with Clostridioides difficile infection (CDI) and microbiome-mediated diseases.
Three major therapeutic strategies identified: additive approaches (FMT, LBPs, defined consortia) aim to restore microbial diversity and colonization resistance Subtractive strategies selectively target C. difficile or its ecological advantages through targeted antibiotics, bacteriocins, bacteriophages, and CRISPR-based antimicrobials Modulatory therapies reshape host–microbe and microbe–microbe interactions, targeting toxin activity, bile acid metabolism, and spore germination
No efficacy, safety, or comparative effectiveness data reported; review does not quantify outcomes or head-to-head comparisons
Clinicians and researchers may use this framework to understand and compare distinct microbiome therapeutic strategies for CDI and to guide selection or design of multimodal approaches. The conceptual organization supports informed choice among additive, subtractive, and modulatory tactics tailored to disease mechanism.
A narrative review synthesizing current evidence and conceptual frameworks for microbiome-based CDI therapeutics, intended to guide clinical practice and future research design rather than report new empirical findings.
As stated by the source record.
Clinicians and researchers may use this framework to understand and compare distinct microbiome therapeutic strategies for CDI and to guide selection or design of multimodal approaches. The conceptual organization supports informed choice among additive, subtractive, and modulatory tactics tailored to disease mechanism.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
What is missing. This record has no reported figures. That is a gap in the analysis, not a judgement about the study.
Microbiome-based therapeutics have rapidly evolved into a transformative field at the intersection of infectious diseases, microbial ecology, and precision medicine. Clostridioides difficile infection (CDI) represents the most extensively studied model, providing a framework for understanding microbiome-driven disease and ecological restoration. This review synthesizes three major therapeutic strategies, additive, subtractive, and modulatory, and integrates recent advances from basic, translational, and clinical research. Additive approaches, including fecal microbiota transplantation (FMT), live biotherapeutic products (LBPs), and defined microbial consortia, aim to restore microbial diversity and colonization resistance. Subtractive strategies selectively target C. difficile or its ecological advantages through targeted antibiotics, bacteriocins, bacteriophages, and CRISPR-based antimicrobials. Modulatory therapies reshape host–microbe and microbe–microbe interactions, targeting toxin activity, bile acid metabolism, and spore germination. Together, these approaches reflect a paradigm shift from pathogen-centered treatment toward ecological therapeutics targeting the dysbiotic niche underlying CDI persistence and recurrence. Understanding the similarities and differences between these strategies can help guide the design of future microbiome-targeted interventions and explore their potential beyond CDI across microbiome-mediated diseases.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.