C. Diff Treatment Significantly Reduces Recurrent Infections
A new treatment for Clostridium difficile (C. diff) may significantly reduce recurrent infections, according to a large study published in the New England Journal of Medicine.
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C. diff is a bacterium that infects the bowel, making it the most common cause of infectious diarrhea in hospitalized patients. Additionally, even after antibiotic treatment, recurrences are common, causing readmissions to the hospital and threating patient-wellbeing
In a study led by Mark Wilcox, University of Leeds, researchers conducted two double-blind, randomized, placebo-controlled, phase 3 trials involving 2655 patients receiving oral standard-of-care for primary or recurrent C. Diff. Patients included in the study were administered an infusion of bezlotoxumab (10 mg per kilogram of body weight), actoxumab plus bezlotoxumab (10 mg per kilogram each), or placebo. There was also a group that received actoxumab alone; however, it was discontinued after a planned interim analysis. The primary endpoint of the study was recurrent infection within 12 weeks after infusion in the modified intention-to-treat population.
At 12 weeks, both trials demonstrated that bezlotoxumab significantly reduced the rate of C. diff recurrence versus placebo (17% [67 of 386 patients] vs 28% [109 of 395]). However, the rate of recurrence was only slightly lower among those who received both actoxumab and bezlotoxumab compared with placebo (16% [61 of 383] vs 28% [109 of 395]).
Overall, among those in the actoxumab group, the bezlotoxumab group, the bezlotoxumab plus actoxumab group, and the placebo group, 26%, 17%, 15%, and 27%, developed another C. diff infection during the study period, respectively.
From these results, authors of the study concluded that bezlotoxumab may safely improve outcomes for patients receiving antibiotic treatment for primary or recurrent C. diff, though the addition actoxumab has little added benefit.
“Fewer recurrent infections would mean less need to use antibiotics, fewer hospital admissions, reduced costs for the NHS and possibly a reduction in deaths,” Dr Wilcox said in a press statement released alongside the study. “Doctors should now consider which patients could best benefit from use of bezlotoxumab.”—Sean McGuire
References
Wilcox MH, Gerding DN, Poxton IR, et al. Bezlotoxumab for Prevention of Recurrent Clostridium Difficile Infection. N Engl J Med. 2017;376(4):305-317.
New C.diff treatment reduces recurrent infections by 40%. University of Leeds Website. https://bit.ly/2kC2yTG. Published January 26, 2017. Accessed January 27, 2017.
