Treatment of Recurrent Clostridioides difficile Infection Within the Last 6 Months
Clinical Scenario
This protocol addresses patients who have experienced a recurrent episode of Clostridioides difficile infection (CDI) within the preceding 6 months. Recurrence in this timeframe represents a distinct clinical situation that calls for a targeted management approach beyond a repeat course of standard antibiotics alone.
Treatment Approach
Current evidence supports the use of an adjunctive intravenous agent, bezlotoxumab, administered alongside standard-of-care antibiotics in this recurrent setting. In patients with a history of congestive heart failure, the use of bezlotoxumab requires careful benefit-risk assessment.
Full regimen details, sequencing, and the complete evidence summary are available in the structured protocol →
Treatment Goal
The primary objective is a reduced risk of a subsequent CDI recurrence following initial clinical cure, with outcomes assessed at 12 weeks.
References
DOI: 10.1093/cid/ciab549
- For patients with a recurrent CDI episode within the last 6 months, we suggest using bezlotoxumab as a co-intervention along with SOC antibiotics rather than SOC antibiotics alone (conditional recommendation, very low certainty of evidence).
- The Food and Drug Administration warns that "in patients with a history of congestive heart failure (CHF), bezlotoxumab should be reserved for use when the benefit outweighs the risk."
- The panel suggests using bezlotoxumab as a co-intervention along with SOC antibiotics for patients with a recurrent CDI within the last 6 months to reduce the risk of a subsequent CDI recurrence after initial clinical cure.
View source ↗