Treating C. Difficile: Medicine to Prevent a Repeat Infection
Clostridium difficile (C. diff) are bacteria that can infect your large intestine. Your large intestine has millions of other bacteria. Many of them help keep you healthy. If you take an antibiotic to cure an infection, the medicine will kill the bacteria causing the infection. But it will also kill the good bacteria in your large intestine.
When these good bacteria are killed, C. diff bacteria can multiply. These bacteria release toxins in the intestine that cause symptoms such as diarrhea and belly (abdominal) pain.
To treat a C. diff infection, your healthcare provider will have you stop taking the antibiotic that caused the C. diff to multiply. You will likely take a different antibiotic to treat the C. diff. Treatment for C. diff stops the symptoms.
In some people, the symptoms come back after a short time (relapse). If you are being treated for C. diff and are at risk for a relapse, your healthcare provider may prescribe an additional medicine. This medicine is called bezlotoxumab. It helps stop the infection and symptoms from coming back. It’s given to adults ages 18 and older who are being treated for C. diff and are at high risk of having another C. diff infection.
Why is bezlotoxumab used?
After an infection of C. diff is treated, symptoms can come back weeks or months later. This may happen because the first treatment did not cure the infection. Or it may happen because you were infected again with C. diff. Getting a C. diff infection a second time is more likely if you are in places where C. diff spreads more easily, such as a hospital or nursing care facility. It can happen if your immune system is not working normally. This may be the case if you have a disease that affects the immune system or if you are an elderly adult. Or you may be taking medicine to lessen the response of your immune system. Bezlotoxumab can help prevent C. diff symptoms from coming back.
How does it work?
The medicine is a human monoclonal antibody. Antibodies are chemicals made by the immune system to fight illness. The medicine is an antibody created to work just like a person’s own immune system. The medicine stops one of the toxins made by the C. diff bacteria. Bezlotoxumab does not treat the infection or kill the bacteria, so it is only used along with the antibiotic medicine used to treat C. diff.
Before your treatment
Tell your healthcare provider if any of the below apply to you:
You are pregnant or may be pregnant. This medicine hasn't been tested on pregnant women. Researchers don’t yet know the effects on a baby in the womb.
You are breastfeeding. This medicine hasn't been tested on breastfeeding women. Researchers don’t yet know if the medicine can show up in breastmilk.
You have congestive heart failure (CHF). Heart failure and death after treatment are more common in people with CHF who are treated with this medicine.
Have high blood pressure. The medicine may cause blood pressure to rise on the day of treatment.
Talk with your healthcare provider about the risks and benefits to you before treatment.
How the medicine is given
Bezlotoxumab is a liquid medicine that is given through an IV line into a vein. A healthcare provider will put a needle into a vein in your arm or hand. A thin, flexible tube (catheter) is then put into the vein. The medicine drips slowly through the tube into your vein. It takes about 1 hour to complete the treatment. You get this treatment just one time while you are taking the antibiotics.
Possible side effects on the day of treatment can include:
Feeling short of breath
High blood pressure
Possible side effects within 4 weeks of treatment can include:
Tell your healthcare providers if you have any other side effects not listed here.
March 21, 2017
FDA Approves Merck’s ZINPLAVA (bezlotoxumab) to Reduce Recurrence of Clostridium difficile Infection (CDI) in Adult Patients Receiving Antibacterial Drug Treatment for CDI Who Are at High Risk of CDI Recurrence. Merck Newsroom, October 2016., New Antimicrobial Stewardship Standard. Joint Commission Perspective. 2016 July;36(7):1-4., Zinplava (bezlotoxumab). Patient Information.
Godsey, Cynthia, MSN, APRN, MSHE, FNP-BC,Hanrahan, John, MD