Treating C.dif

iStock-485935060C.dif is the abbreviation for one scourge of modern healthcare: an infection that often results in severe diarrhea, is challenging to treat, recurs readily, and may result in death. Now, as Rick and I discuss on PodMed this week and published in the New England Journal of Medicine, hope has arrived in the form of a new antibody to treat C. dif, or Clostridium difficile.

Turns out there are two antibodies against toxins produced by the organism reported in NEJM this week, but only the one against toxin B, known as bezlotoxumab, turned out to be much help. Over 2500 adults with primary or recurrent C.dif infection were included in this study, all of whom received standard oral antibiotics, followed by one or both antibodies or placebo. Those who received bezlotoxumab were more likely to achieve a sustained cure, that is no recurrence after initial clinical cure within 12 weeks, than those who received both antibodies or placebo.

The antibodies were administered by a single IV infusion following routine antibiotic therapy. The most common side effects reported by 2% of subjects included nausea and headache. Rick and I agree that these are impressive results and might be improved with more than one dose of the antibody or combination with fecal transplant.  Rick also advised me that the drug has just been approved by the FDA, so should soon be available widely.

Other topics this week include Association of Patient-Physician Language Concordance and Glycemic Control for Limited–English Proficiency Latinos With Type 2 Diabetes in JAMA Internal Medicine, a method for assessing medical devices once they're on the market Prospective Surveillance of Medical-Device Safety in NEJM, and Physician Decision Making and Clinical Outcomes With Laboratory Polysomnography or Limited-Channel Sleep Studies for Obstructive Sleep ApneaA Randomized Trial in Annals of Internal Medicine. Until next week, y'all live well.

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