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Bezlotoxumab in Patients with a Primary Clostridioides difficile Infection: A Literature Review

Guido Granata1, Francesco Schiavone2, Giuseppe Pipitone3

  • 1Clinical and Research Department for Infectious Diseases, National Institute for Infectious Diseases L. Spallanzani, IRCCS, 00149 Rome, Italy.

Antibiotics (Basel, Switzerland)
|November 11, 2022
PubMed

Insights

Bezlotoxumab effectively prevents recurrent Clostridioides difficile infection (CDI) when given with antibiotics. This monoclonal antibody reduces recurrence rates in patients experiencing their first CDI episode, offering a new management strategy.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Clinical Medicine

Background:

  • Recurrent Clostridioides difficile infection (rCDI) presents a significant challenge in patient management, leading to increased mortality and healthcare expenses.
  • High recurrence rates necessitate novel therapeutic strategies to improve patient outcomes and reduce the economic burden of CDI.

Purpose of the Study:

  • To evaluate the efficacy and safety of bezlotoxumab in preventing rCDI following a primary CDI episode.
  • To synthesize current evidence on bezlotoxumab's role in mitigating CDI recurrence.

Main Methods:

  • A comprehensive literature search was conducted using PubMed with terms including "bezlotoxumab" and "Clostridioides difficile infection" (CDI).
  • Searches covered articles published up to August 31, 2022, with a focus on studies involving bezlotoxumab for primary CDI prevention.
  • References from retrieved articles were also reviewed to identify additional relevant studies.

Main Results:

  • Five studies, including a Phase III trial and its sub-analyses, met the inclusion criteria.
  • In the Phase III trial, bezlotoxumab reduced rCDI rates from 20.9% in the placebo group to 13.5% at 12 weeks (absolute difference: -7.4%).

Conclusions:

  • Bezlotoxumab is a safe and effective adjunct to standard antibiotic therapy for reducing rCDI.
  • Consideration of bezlotoxumab for patients with a primary CDI episode is supported by current evidence, despite its cost.
  • Further research is warranted to identify specific patient subgroups and risk factors that may benefit most from bezlotoxumab treatment.
Abstract

Keywords:
CDI recurrence preventionClostridioides difficileTcdBbezlotoxumabcost-effectivenesshealth care costpreventionprimary CDIrecurrence of CDItoxin

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