Lifestyle and Recurrent Clostridioides Difficile Infection (CDI)
Diet for Prevention of Recurrent C. Difficile Infection
This study aims to evaluate the impact of diet on the gut microbiome in adults with Clostridioides difficile infection (CDI). Eligible participants will be randomized and receive meals plus different types of health counseling. Counseling visits will be by phone or online videoconference (e.g. Zoom). Meals will be provided for two weeks and then participants will be asked to continue similar meals for 6 more weeks.
Participants will provide responses to questionnaires and multiple stool samples over the course of the study. The goal is to understand how different health factors might impact the risk of becoming infected again with C. difficile in the future.
Of note, this study will conceal the intervention details (type of diets) so that the control group does not increase their intake with the particular diet during the study. Participants in the control arm will be unblinded at the end of the study during a debrief with a member of the study team. At that time participants will be informed of diet being tested.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Kira Newman, MD, PhD
- Phone Number: 734-615-4628
- Email: kinewman@med.umich.edu
Study Locations
-
-
Michigan
-
Ann Arbor, Michigan, United States, 48109
- Recruiting
- University of Michigan
-
Contact:
- Kira Newman, MD, PhD
- Phone Number: 734-615-4628
- Email: kinewman@med.umich.edu
-
Principal Investigator:
- Kira Newman, MD, PhD
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Provision of signed and dated informed consent form
- Stated willingness to comply with all study procedures and lifestyle considerations and availability for the duration of the study
- Non-recurrent non-fulminant CDI (laboratory-confirmed C. difficile infection without prior C. difficile infection within 3 months and no shock, hypotension, ileus, or megacolon)
- Currently receiving treatment or with plan to initiate treatment for CDI
- CDI treatment with standard regimen (fidaxomicin 200milligrams (mg) by mouth (PO) twice a day x 10-14 days or vancomycin 125mg PO 4 x a day (QID) x 10-14 days)
- No prior advanced therapy for C. difficile (i.e. prolonged antibiotic therapy, bezlotoxumab, fecal transplant, other microbial therapy)
Exclusion Criteria:
- Chemotherapy, immunotherapy, or transplant within 12 months
- Colon not in continuity (i.e. status post total colectomy or with current ileostomy)
- Medical comorbidities requiring specific fluid, sodium, or protein intake level outside range of prepared diet options
- Baseline diet with > 11grams fiber/1000 kilocalories
- Low sodium diet, vegan diet, gluten-free diet, Kosher diet or any other diet not able to be accommodated by the metabolic kitchen
- Allergies, food preferences, or other restrictions not able to be accommodated by the metabolic (note: lactose intolerance will not impact eligibility)
- Unwilling to stop probiotic supplements during the study period
- Current antibiotic therapy that will continue after CDI treatment has finished
- Hospitalized or in skilled nursing facility at time of CDI treatment conclusion
- Pregnancy or breast-feeding
- Unable to provide a stool sample of appropriate quality for further analysis (i.e. low volume, adulterated, delayed return, etc.)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Experimental Diet plus health counseling
As stated earlier, the diet and intervention details will not be listed for concealment purposes.
|
Participants will receive 2 weeks of prepared meals.
Participants will then be asked to follow a similar diet for 6 weeks.
|
|
Other: Diet (control diet per protocol) plus health counseling
As stated earlier, the diet and intervention details will not be listed for concealment purposes.
|
Participant will have two health counseling visits with a member of the study team between weeks 2-8.
Participants will receive 2 weeks of prepared meals.
Participants will then be asked to follow a similar diet for 6 weeks.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change from baseline to week 2 in alpha-diversity of fecal microbiome by 16S rRNA sequencing
Time Frame: Baseline, 2 weeks (post feeding period)
|
Change from baseline to week 2 (post feeding period) in alpha-diversity of fecal microbiome by 16S rRNA sequencing using Shannon index.
|
Baseline, 2 weeks (post feeding period)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change from baseline to week 8 in microbiome alpha-diversity (Shannon Index via 16S rRNA)
Time Frame: baseline to week 8
|
Measured by Shannon Index via 16S rRNA.
|
baseline to week 8
|
|
Incidence of recurrent CDI
Time Frame: baseline to week 8
|
Laboratory-confirmed symptomatic infection requiring treatment.
|
baseline to week 8
|
|
Change in CDI-related Quality of Life (QOL) baseline to Week 8
Time Frame: Baseline to Week 8
|
Patient-reported health-related quality of life assessed using the Clostridioides difficile Quality of Life Survey (Cdiff32) total score (range 0-100; higher scores indicate better quality of life).
|
Baseline to Week 8
|
|
Tolerability of diet based on the mean percent of meals consumed during the first 2 weeks
Time Frame: 2 weeks (during the provided meal period)
|
This is during the 2-weeks of receiving provided meals.
|
2 weeks (during the provided meal period)
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Kira Newman, MD, PhD, University of Michigan
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- HUM00284257
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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