Study Confirms Efficacy of Bezlotoxumab in Preventing C. Diff Among Transplant Recipients


Recurrent C. diff infections were observed in 16% of patients who received bezlotoxumab, compared with 29% of patients who received standard of care alone.

Although bezlotoxumab is known to reduce the incidence of recurring Clostridioides difficile (C diff.) infection, a new study investigated and confirmed its efficacy among patients who have received solid-organ transplants.

Researchers conducted a single-center retrospective analysis to compare recurrent C. diff infections among patients who have received solid organ and hematopoietic cell transplants and who were treated with standard of care alone or bezlotoxumab plus standard of care. Standard of care included oral vancomycin, fidaxomicin, or metronidazole.

According to the study results, 38 patients received bezlotoxumab plus standard of care and 56 received standard of care alone. Participants had a mean age of 53 years, a median of 3 prior C. diff infections, and 4 risk factors for recurrent infection. Most were solid-organ transplant recipients (76%), with a median time to infection occurring 2.7 years post-transplantation.

Ninety-day recurrent C. diff occurred in 6 of the 38 patients (16%) receiving bezlotoxumab, compared to 16 of the 56 people (29%) in the standard of care cohort. After performing a multivariable regression, the researchers found that bezlotoxumab was associated with significantly lower odds of 90-day recurrent infection.

There were no differences observed in the secondary outcomes, which included 90-day hospital readmission, mortality, and incidence of heart failure exacerbation.

Based on these findings, the researchers concluded that bezlotoxumab was well-tolerated and associated with lower odds of recurrent C. diff infection at 90 days. However, they added that larger, prospective trials are necessary to confirm these findings among solid-organ and hematopoietic-cell transplant recipients.


Johnson T, Howard A, Miller M, Allen L, et al. Effectiveness of bezlotoxumab for prevention of recurrent Clostridioides difficile infection among transplant recipients. Open Forum Infectious Diseases. Accessed June 23, 2021.

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