Clinical Implications of Bezlotoxumab for Recurring C Diff Infections

Segment Description: Dale N. Gerding, MD, research physician at Edward Hines Jr. VA Hospital, discusses bezlotoxumab and its use for preventing recurrent Clostridium difficile infections.

Interview Transcript: (modified slightly for readability):

“Zinplava, which is bezlotoxumab, a monoclonal antibody targeting toxin B specifically, is given intravenously and should be used in situations where patients are at high risk of recurrence for C diff infections. It’s designed to prevent recurrence of disease; it is not designed to prevent primary infection.

The way it works is that the monoclonal antibody will tie up toxin in the gut of the patient so that the toxin is no longer able to produce the symptoms of C diff infection.

We think it’s best use—and this is clear from the trials that have been done—is in patients who are elderly, who have immune suppression, who have had severe C diff disease, who are having recurrent disease; [these patients] are really the ones who are going to benefit the most.

If patients have no risk factors, there probably is no benefit to be given bezlotoxumab. On the other hand, if they have an accumulation of risk factors—1, 2, 3—the more risk factors they have the more likely they are to benefit from it.”