Bezlotoxumab as Secondary Prophylaxis for C. Difficile in High-risk Hospitalized Patients Exposed to Antibiotics.
Bezlotoxumab as Secondary Prophylaxis for C. Difficile in High-risk Hospitalized Patients Exposed to Antibiotics.
This study will examine whether the human monoclonal antibody, bezlotoxumab administered
 AFTER acute Clostridioides difficile (C.diff) has resolved, but during a period of subsequent
 antibiotic therapy, will eliminate the high risk of C. diff relapse.
Clostridioides difficile (C. diff) is a germ (bacteria) that causes life-threatening
 diarrhea. It is usually a side-effect of taking antibiotics that affect the normal balance of
 bacteria in the intestines. When the "good bacteria" in the intestine are killed by
 antibiotics, the C.diff bacteria begin to grow and produce toxins, causing frequent diarrhea
 and other symptoms such as abdominal pain or tenderness, loss of appetite, low-grade fever,
 nausea and vomiting. C. diff can be treated by using special antibiotics, but it tends to
 come back in about 20% of patients. C-diff is problematic because of frequent relapses after
 apparent cure. The greatest risk factor for relapse is receipt of subsequent antibiotics, in
 the hospital, shortly after being treated.

 Zinplava™(bezlotoxumab) is an FDA approved human monoclonal antibody designed to prevent the
 recurrence of C.diff.This is not an antibiotic, as it does not kill C. diff, but is an
 antibody to C. diff toxins, which stops the damage. When Bezlotoxumab is given during a C.
 diff infection together with antibiotics to kill C. diff, it decreases the risk that C. diff
 will come back by about one-half. Bezlotoxumab is approved for use when given during a C.
 diff infection, but it has not been used to prevent C diff in other situations, such as the
 one being studied in this research.
Inclusion Criteria:

 -  C diff diagnosed within 90 days

 -  Receipt of high-risk antibiotics for C diff (e.g. Beta-lactams, carbapenems) in an
 inpatient setting

 -  Age 60 years and older

 Exclusion Criteria:

 -  Receipt of current C.diff active antibiotics (oral vancomycin, fidaxomycin,
 metronidazole, tigecycline/ doxycycline, nitazoxanide, rifamycin) within 72hrs.

 -  Not Expected to survive 8 weeks

 -  Prior or planned fecal microbiota transplant or Bezlotoxumab use

 -  Congestive heart failure (a potential risk of Bezlotoxumab)