Ramaiah medical college Bangalore, Karnataka, India
Keerthi Balaji Babu Naidu, 1, Vinay Chandramouli Bellur, 1, Ananya Prasad, 2, Omar Oudit, DO3, Pavan Kumara Kasam Shiva, 4, Vibhav MS, 4, Swaroop Raj Varma K R, 4, Rishikesh R. Magaji, 5, Shradha Chervittara Karaveetil, 2, Trisha Chandra Mohan, 5, Deepika A, 4, Gaurav Jayadev, 6, Druvadeep Srinivas, 7, Tanay Kapoor, 2, Deepak Bhat, MBBS8, Anusha Giri, 2, Prakriti Ramamurthy, MBBS, MD9, Sravani Bhavanam, 10 1Ramaiah medical college, Bangalore, Karnataka, India; 2ramaiah medical college, Bangalore, Karnataka, India; 3Brookdale University Hospital Medical Center, Brooklyn, NY; 4bangalore medical college and research institute, Bangalore, Karnataka, India; 5BGS Global Institute of Medical Sciences, Bangalore, Karnataka, India; 6basaveshwara medical college and hospital, Bangalore, Karnataka, India; 7rajarajeshwari medical college & hospital, Bangalore, Karnataka, India; 8M. S Ramaiah Medical College, Bangalore North, Karnataka, India; 9University of Massachusetts Chan Medical School - Baystate Health, Springfield, MA; 10Brookdale University Hospital Medical Center, Bangalore, Karnataka, India Introduction: Clostridioides difficile infection (CDI) management remains one of the most persistent clinical challenges. Despite successful treatment, nearly 30% of patients experience recurrence. RecurrentCDI (rCDI) poses significant risk of serious complications. Furthermore, patients who have a first recurrence face an even higher risk of second recurrence. Our study aims to explore the efficacy of Bezlotoxumab(BZX) in reducing the risk of rCDI. Methods: The review conducted follows the PRISMA guidelines and major medical databases, which include PUBMED, Google Scholar and Science-Direct, were extensively searched using a comprehensive search term to identify and retrieve available articles. The articles which included the assessment of recurrence events of CDI following BZX infusion and standard treatment were included in the final analysis. The data was analysed using the Meta, Metadata and the Metafor packages of R Studio. The proportion of the Odds Ratio (OR) of recurrence of CDI was assessed as our primary outcome. The OR of initial cure rates following treatment of recurrent CDI was assessed. The data was analysed using the Meta, Metadata and the Metafor packages of R Studio. The Mantel- Haenszel method (common effect model)and the Inverse variance method (random effects model) was utilised to analyse the odds ratio. Results: The review includes a total of 10 articles that assessed the recurrence rates of CDI infection following BZX infusion and standard care. There were 2926 patients in the BZX administration group and 2638 patients of the control group. The primary outcome assessed was the odds ratio of recurrence of CDI infection between the 2 groups , the odds of a recurrence of CDI was significantly lower in the BZX infusion group in comparison to the standard treatment protocol( OR = 0.59 (0.54;0.65) , 95% CI ; p = 0.67 , I^2 = 0%). The initial cure rate was assessed in 4 articles , the initial cure rates did not significantly differ between the 2 groups(OR = 1.00(0.97;1.03) , p = 0.91 , I^2 = 0%). Discussion: Our study supports the utility of Bezlotoxumab (BZX) as an effective monoclonal antibody for reducing recurrence rates in rCDI, particularly among high-risk groups. However, use of BZX did not translate into higher initial cure rates.
Figure: initial cure rates in bezlotoxumab vs standard care in recurrent C. Difficle infection
Figure: recurrence rates in bezlotoxumab vs standard care in recurrent C. Difficle infection
Disclosures: Keerthi Balaji Babu Naidu indicated no relevant financial relationships. Vinay Chandramouli Bellur indicated no relevant financial relationships. Ananya Prasad indicated no relevant financial relationships. Omar Oudit indicated no relevant financial relationships. Pavan Kumara Kasam Shiva indicated no relevant financial relationships. Vibhav MS indicated no relevant financial relationships. Swaroop Raj Varma K R indicated no relevant financial relationships. Rishikesh R. Magaji indicated no relevant financial relationships. Shradha Chervittara Karaveetil indicated no relevant financial relationships. Trisha Chandra Mohan indicated no relevant financial relationships. Deepika A indicated no relevant financial relationships. Gaurav Jayadev indicated no relevant financial relationships. Druvadeep Srinivas indicated no relevant financial relationships. Tanay Kapoor indicated no relevant financial relationships. Deepak Bhat indicated no relevant financial relationships. Anusha Giri indicated no relevant financial relationships. Prakriti Ramamurthy indicated no relevant financial relationships. Sravani Bhavanam indicated no relevant financial relationships.
Keerthi Balaji Babu Naidu, 1, Vinay Chandramouli Bellur, 1, Ananya Prasad, 2, Omar Oudit, DO3, Pavan Kumara Kasam Shiva, 4, Vibhav MS, 4, Swaroop Raj Varma K R, 4, Rishikesh R. Magaji, 5, Shradha Chervittara Karaveetil, 2, Trisha Chandra Mohan, 5, Deepika A, 4, Gaurav Jayadev, 6, Druvadeep Srinivas, 7, Tanay Kapoor, 2, Deepak Bhat, MBBS8, Anusha Giri, 2, Prakriti Ramamurthy, MBBS, MD9, Sravani Bhavanam, 10. P5560 - Efficacy of Bezlotoxumab in Recurrent <i>Clostridioides difficile</i> Infection: A Systematic Review and Meta-Analysis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
