Bezlotoxumab (Zinplava™) is a fully human monoclonal antibody against 
Clostridium difficile toxin B indicated for the prevention of C. difficile 
infection (CDI) recurrence in patients with a high recurrence risk. It is the 
first agent approved for recurrence prevention and is administered as a single 
intravenous infusion in conjunction with standard-of-care (SoC) antibacterial 
treatment for CDI. In well-designed, placebo-controlled, phase 3 trials (MODIFY 
1 and 2), a single infusion of bezlotoxumab, given in combination with SoC 
antibacterial therapy for CDI in adults, was effective in reducing CDI 
recurrence in the 12 weeks post-treatment, with this benefit being seen mainly 
in the patients at high recurrence risk. Bezlotoxumab did not impact the 
efficacy of the antibacterials being used to treat the CDI and, consistent with 
its benefits on CDI recurrence, appeared to reduce the need for subsequent 
antibacterials, thus minimizing further gut microbiota disruption. Longer term, 
there were no further CDI recurrences over 12 months' follow-up among patients 
who had received bezlotoxumab in MODIFY 2 and entered an extension substudy. 
Bezlotoxumab has low immunogenicity and is generally well tolerated, although 
the potential for heart failure in some patients requires consideration; 
cost-effectiveness data for bezlotoxumab are awaited with interest. Thus, a 
single intravenous infusion of bezlotoxumab during SoC antibacterial treatment 
for CDI is an emerging option for reducing CDI recurrence in adults at high risk 
of recurrence.