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Am Fam Physician. 2024;109(5):472-473

Author disclosure: No relevant financial relationships.

Fecal microbiota spores, live-brpk (Vowst) is a capsule of bacterial spore suspension taken orally. It is labeled for the prevention of Clostridioides difficile infection in adults who have recurrent C. difficile infection (i.e., three or more episodes within 12 months). Vowst is taken 2 to 4 days following antibiotic therapy for recurrent C. difficile infection. It is manufactured from human donor fecal matter that contains live, purified Firmicutes spores, which are thought to restore intestinal flora.1

DrugDosageDose formCost*
Fecal microbiota spores, live-brpk (Vowst)Four capsules taken orally once daily on an empty stomach for 3 consecutive daysCapsule (containing between 1 × 106 and 3 × 107 Firmicutes spore colony-forming units in 92% ± 4% glycerol in saline)$19,500
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STEPS new drug reviews cover Safety, Tolerability, Effectiveness, Price, and Simplicity. Each independent review is provided by authors who have no financial association with the drug manufacturer.

This series is coordinated by Allen F. Shaughnessy, PharmD, assistant medical editor.

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