Clinicians should assess the benefits and risks of using bezlotoxumab for reducing the risk of recurrent Clostridium difficile infection.

Abstract

Commentry on: Wilcox MH, Gerding DN, Poxton IR, et al . Bezlotoxumab for Prevention of Recurrent Clostridium difficile Infection. N Engl J Med 2017;376:305–317. Clostridium difficile is an anaerobic gram-positive spore-forming bacillus that plays a major role in healthcare antibiotic-associated diarrhoea. A continued rise in antibiotic use, specifically, cephalosporins and fluoroquinolones, has been linked to the development of more resistant strains of this toxin-forming pathogen, triggering more recurrences and severe manifestations of the disease across USA and Europe.1 The high burden of recurrence and increased healthcare costs associated with C. difficile infection (CDI) have encouraged the development of new treatments to prevent recurrence including the use of pulsed/tapered oral vancomycin, fidaxomicin and faecal microbiota transplantation (FMT).2 Monoclonal antibodies for C. difficile therapy (MODIFY) trials I and II are two global phase 3 trials aimed at examining the efficacy and safety of a single dose (10 mg/kg) of human monoclonal antibodies actoxumab and bezlotoxumab against C. …