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 some of 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 might have you stop taking the antibiotic that caused the C. diff to multiply, if possible. You will likely be given a different antibiotic to treat the C. diff. Treatment for C. diff stops the symptoms.

In some people, the symptoms come back after treatment (relapse). If you are being treated for C. diff and are at risk for a relapse, your provider may prescribe an additional medicine. This medicine is called bezlotoxumab. In some people, it can lower the chance of the symptoms coming back. It can be 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, or already have recurrent C. diff infection. Other treatments are also available for recurrent C. diff infection. Talk with your healthcare provider about which medicine is right for you.

Why is bezlotoxumab used? 

After an infection of C. diff is treated, symptoms may come back weeks or months later. This may happen because the first treatment did not fully cure the infection. Or it may happen because you were infected again with C. diff. Getting 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 long-term 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 older adult. Or you may be taking medicine to lessen the response of your immune system. Repeat cases of C. diff can also occur if you take antibiotics again. Bezlotoxumab has been shown to lower the risk of recurrent C. diff by about 10%. It's expensive. Check with your insurance company to see what your coverage is for this medicine.

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's 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 uterus.

  • You are breastfeeding. This medicine hasn't been tested on breastfeeding people. Researchers don’t yet know if the medicine can show up in breastmilk.

  • You have heart failure. Heart failure and death after treatment are more common in people with heart failure 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 (intravenous) 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. 

Side effects 

Possible side effects on the day of treatment can include:

  • Upset stomach (nausea)

  • Headache

  • Fever

  • Dizzy feeling

  • Feeling short of breath

  • Tiredness

  • High blood pressure 

Possible side effects within 4 weeks of treatment can include:

  • Nausea

  • Fever

  • Headache 

Tell your healthcare provider if you have any other side effects not listed here.

Online Medical Reviewer: Barry Zingman MD
Online Medical Reviewer: L Renee Watson MSN RN
Online Medical Reviewer: Marianne Fraser MSN RN
Date Last Reviewed: 3/1/2022
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