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RecruitingNCT06451913SUBLYMEUpdated Aug 27, 2025

Effect of Saccharomyces Boulardii CNCM I-745 on Gut Microbiota in Patients Undergoing Antibiotic Therapy (in the Context of Erythema Migrans (Early Skin Form of Lyme Borreliosis))

A Phase 4 interventional study of Amoxicillin + Saccharomyces boulardii CNCM I-745 and Amoxicillin + Placebo in Erythema Migrans of Lyme Disease, sponsored by Biocodex. Recruiting at 1 site in Slovenia. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-08-27.

Sponsored by Biocodex · Phase 4, Interventional, and Supportive care

From the registry’s dates

  • Started Jul 2025; still recruiting 1 year 3 months later.
Phase
Phase 4
Study type
Interventional
Enrollment
120
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The aim of this study is to assess the effect of Saccharomyces boulardii CNCM I-745 on gut microbiota in patients undergoing antibiotic therapy (in the context of erythema migrans (early skin form of Lyme borreliosis)).

Read the detailed description

The study is designed to compare the efficacy of Saccharomyces boulardii CNCM-I-745 500 mg bid to a placebo in patients undergoing antibiotic therapy in the context of erythema migrans as the early form of Lyme borreliosis.

02

Conditions studied

  • Erythema Migrans of Lyme Disease

Keywords

  • Erythema Migrans
  • Lyme Disease
  • Gut microbiota
  • Saccharomyces boulardii CNCM I-745
  • Lyme borreliosis
03

In context

Glossitis, Benign Migratory

25 studies on the registry are indexed under Glossitis, Benign Migratory; 4 are open to participants now.

This study's planned enrollment of 120 is below the median of 200 across 13 interventional studies indexed under Glossitis, Benign Migratory.

Browse Glossitis, Benign Migratory studies →

Lead sponsor

Biocodex is the lead sponsor of 19 studies on the registry; 6 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Adult Patients, ≥18 years old.
  • Who are prescribed antibiotic therapy (as per medical routine practices, amoxicillin 1000 mg bid for 14 days) in the context of erythema migrans (early skin form of Lyme borreliosis).
  • Able to comply with study requirements and to provide signed before any study procedure.
  • Has no condition that may interfere with the study assessments.
  • Able to fulfil in the diary stool log, according to the physician's opinion.
  • Regular defecation (frequency and stool consistency, with at least about three bowel movements a week).
  • For women of :
  • A negative urine pregnancy test immediately prior to starting the study treatment,
  • Agreement to comply with approved methods of during the whole study: unless they meet the criteria of , i.e. 12 months of spontaneous amenorrhea, women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, including women whose career, lifestyle, or sexual orientation precludes intercourse with a male partner, should use one or more acceptable methods of contraception that should be maintained throughout the study.

Exclusion criteria

Exclusion Criteria:

  • History of to the study treatments (active substance or ), brewer's or baker's yeast,
  • and special warning to the study drugs according to the SmPCs,
  • History of chronic constipation with passage of fewer than 3 spontaneous bowel movements per week on average,
  • History of chronic or recurrent diarrhoea with spontaneous unformed bowel movements equivalent to or more often than 3 times daily,
  • Prior gastrointestinal surgery (apart from appendectomy or cholecystectomy performed at least more than one year ago),
  • History of Clostridium difficile infection,
  • Active gastrointestinal inflammatory disease,
  • Known chronic or recurrent systemic disorder that may interfere with the study drug evaluation,
  • (organtransplants, leukaemia, malignant tumours, radiotherapy, chemotherapy,prolonged high dose cortisone treatment, immunosuppressant treament) or critically ill patients (such as disease, ,…), patients with a central venous catheter,
  • Severe hepatic or renal impairment,
  • Systemic antibacterial therapy during the 2 months prior to study enrollment,
  • New prescription medications during the 2 weeks prior to study enrollment,
  • Use of any drug or product that alters gut microbiota or function, such as probiotics, laxatives, antiemetics, cisapride, antisecretory or adsorbent treatments (racecadotril, smectite, activated charcoal), opiates such as loperamide, atropine and other cholinergic agents, 4 weeks prior to study enrollment and during the study,
  • Intake of antifungals within 14 days prior to study enrollment,
  • Substantial changes in eating habits within 30 days prior to receiving the first dose of IMP product, and during the study as assessed by the Investigator,
  • History or presence of drug or alcohol abuse,
  • Heavy smoker (more than 10 cigarettes per day),
  • Breast-feeding woman,
  • Patients enrolled in another interventional clinical trial where they received an investigation treatment within the past 30 days,
  • Any condition or personal circumstance that, in the opinion of the investigator, rendered the subject unlikely or unable to comply with the full study protocol
Terms in these criteria, in plain language(10)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

05

Study design

Phase
Phase 4
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
120 participants (estimated)

Study arms

  • Experimental
    Amoxicillin + Saccharomyces boulardii CNCM I-745

    The patients will received oral Amoxicillin (1000 mg capsules bid) for 14 days and oral Saccharomyces boulardii CNCM I-745 (®) 250 mg x 2 capsules twice a day for 21 days.

    Drug: Amoxicillin + Saccharomyces boulardii CNCM I-745 · Other: Stool samples · Other: BSFS : Bristol Stool Form Scale · Other: GSRS : Gastrointestinal Symptom Rating Scale

  • Placebo comparator
    Amoxicillin + Placebo

    The patients will received oral Amoxicillin (1000 mg capsules bid) for 14 days + oral Placebo capsules for 21 days.

    Drug: Amoxicillin + Placebo · Other: Stool samples · Other: BSFS : Bristol Stool Form Scale · Other: GSRS : Gastrointestinal Symptom Rating Scale

Interventions

  • DrugAmoxicillin + Saccharomyces boulardii CNCM I-745

    At inclusion visit (V1), the Investigator will dispense and ask the subject to take Amoxicillin 1000 mg bid for 14 days + Saccharomyces boulardii 250 mg x 2 twice a day for 21 days

  • DrugAmoxicillin + Placebo

    At inclusion visit (V1),the Investigator will dispense and ask the subject to take Amoxicillin 1000 mg bid for 14 days + a matching placebo bid for 21 days

  • OtherStool samples

    The subject will be asked to collect thanks to four OMNIgene® •GUT OMR-200 kits : * an initial stool collection when returning home at D1 (in any case before any intake of amoxicillin and of the investigational medication and up to 1 day after D1). * a stool collection at home after the phone call 1, Day 7 (stool collection up to Day 7 + 1 day) * a stool collection at home after the phone call 2, Day 14 (stool collection up to Day 14 + 1 day) * at home the day of the Visit 2, Day 21 (stool collection up to Day 21 + 1 day)

  • OtherBSFS : Bristol Stool Form Scale

    All included subjects will have to complete a stool diary BSFS (Bristol Stool Form Scale) daily and at each bowel movement, from Day 1 until the end of study treatment (Day 21). The patient will fill the form with the date, the time, and the stool texture.

  • OtherGSRS : Gastrointestinal Symptom Rating Scale

    All included subjects will have to complete a GSRS (Gastrointestinal Symptom Response Score) questionnaire weekly from Day 1 until the end of the study treatment (Day 21).

06

What researchers measure

Primary outcomes

  1. Assessment of the effect of Saccharomyces boulardii CNCM I-745, an antibiotic, and their combination on the gut microbiota of patients receiving antibiotic

    Primary endpoint : analysis of the intestinal microbiota in the patient's stools

    Time frame: At Day 1, Day 7, Day 14 and Day 21

Secondary outcomes

  1. Assessment of the efficacy of Saccharomyces boulardii CNCM I-745 in prevention of antibiotic-associated diarrhoea (AAD) in patients undergoing antibiotic therapy

    Secondary efficacy endpoint : Incidence of AAD (The number of AAD episodes that occurred during the treatment period) will be assessed using the Bristol Stool Form Scale (BSFS) recorded daily.

    Time frame: At Day 1, Day 7, Day 14 and Day 21

  2. Assessment of the efficacy of Saccharomyces boulardii CNCM I-745 on the stools in patients undergoing antibiotic therapy : Recorded stools in the Bristol Stool Form Scale (BSFS)

    Secondary efficacy endpoint : Time frame in hours up to the time of the last liquid or loose stool (defined as types 6 or 7 on Bristol Stool Form Scale (BSFS)) followed by the first 24-hour period with stool consistency improvement (no liquid or loose stool), as recorded by the patients in the stool diary or as collected by the investigator

    Time frame: At Day 1, Day 7, Day 14 and Day 21

  3. Assess the effect of Saccharomyces boulardii CNCM I-745, an antibiotic, and their combination on the gastro-intestinal symptoms of patients receiving antibiotic therapy : Changes from baseline of the GSRS

    Secondary efficacy endpoint : Changes from baseline of the Gastrointestinal Symptom Rating Scale (GSRS) score (total score) and diarrhea sub-scores will be compared weekly between the treatment groups. The questionnaire, which contains 15 items, uses a seven-graded Likert scale, where 1 represents the most positive option and 7 the most negative one.

    Time frame: Weekly from Day 1 to Day 21

Other outcomes

  1. Assessment of the safety and tolerability of Saccharomyces boulardii CNCM I-745. Recording adverse events

    Safety endpoint : Recorded adverse events (number of events and number of participants with at least one event), vital signs, and physical examination

    Time frame: At each assessment time from baseline (Day 1 to Day 58)

  2. Assess the effect of Saccharomyces boulardii CNCM I-745, an antibiotic, and their combination on the specific gastro-intestinal symptoms of patients receiving antibiotic therapy : Gastrointestinal Symptom Rating scale (GSRS)

    Exploratory endpoint : Changes from baseline of the GSRS subscores (except diarrhea) will be compared weekly between the treatment groups.The questionnaire, which contains 15 items, uses a seven-graded Likert scale, where 1 represents the most positive option and 7 the most negative one.

    Time frame: Weekly from Day 1 to Day 21

  3. Assess the effect of Saccharomyces boulardii CNCM I-745, an antibiotic, and their combination on the gut resistome of patients receiving antibiotic : Changes on the fecal Antimicrobial Resistance Genes (ARGs)

    Exploratory endpoint : Changes observed on the gut resistome, abundance and diversity of the fecal ARGs will be analysed by treatment group and at each assessment time.

    Time frame: At Day 1, Day 7, Day 14 and Day 21

07

Study locations

1 of 1 sites recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 27, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06451913
Lead sponsor
Biocodex
Responsible party
Sponsor
First posted
Jun 11, 2024
Start date
Jul 16, 2025
Primary completion
Dec 2026 (estimated)
Completion
Dec 2026 (estimated)
Last update
Aug 27, 2025

Study contacts

Gaëlle MARIAULE
Contact
g.mariaule@biocodex.fr
03.44.86.82.28 ext. +33
Carine FRANCOIS
Contact
c.francois@biocodex.fr
03.44.86.82.28 ext. z+33
Oana BERNARD, MD
study director · Chief Scientific Officer

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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