PDF(Pubmed)
Abstract：
Clostridium difficile infection (CDI) is the most common nosocomial infection in hospitals. Despite the fact that CDI has treatment options, recurrence is common after the treatment, recurrence will occur in approximately 20%-35% of people initially affected, with 40%-60% of these having a second recurrence. Patients are more likely to have several recurrences after the second, which can lead to antibiotic overuse, and as a result, CDI-related health care expenses, hospitalizations, and mortality are on the rise. The first treatment to receive Food and Drug Administration (FDA) approval for the prevention of C. difficile recurrence is bezlotoxumab, a novel human monoclonal antibody against C. difficile toxin B. In the present systematic review, we assessed various studies from PubMed, PubMed Central (PMC), Google Scholar, and Science direct that evaluated the efficacy of bezlotoxumab in the prevention of recurrent C. difficile (rCDI), and we also briefly discussed the pathophysiology of C. difficile and the risk factors for recurrence of C. difficile. The major MODIFY trial has proven the efficacy, pooled analysis of MODIFY 1 AND 2 trials demonstrated the following results as compared to placebo (bezlotoxumab: 129/781 [16.5] placebo:206/773 [26.6] -10.0% [95% CI -14.0 to -6.0], p<0.0001) with number needed to treat (NNT) of 10. All other observational studies also showed a positive response with bezlotoxumab in the prevention of C. difficile. In conclusion, bezlotoxumab is a great option adjunctive with standard of care CDI antibiotics for the prevention of rCDI in high-risk adults.
摘要：
艰难梭菌感染（CDI）是医院最常见的医院感染。尽管CDI有治疗选择，治疗后复发很常见，复发将发生在大约20％-35％的最初受影响的人，其中40%-60%有第二次复发。患者在第二次之后更有可能出现几次复发，这会导致抗生素的过度使用，结果，与CDI相关的医疗保健费用，住院治疗,死亡率也在上升.第一个获得美国食品和药物管理局（FDA）批准的用于预防艰难梭菌复发的治疗方法是bezlotoxumab，一种针对艰难梭菌毒素B的新型人单克隆抗体。我们评估了PubMed的各种研究，PubMedCentral(PMC),谷歌学者，和科学指导评估贝兹洛妥单抗预防复发性艰难梭菌（rCDI）的疗效，我们还简要讨论了艰难梭菌的病理生理学和艰难梭菌复发的危险因素。主要的MODIFY试验已经证明了这种疗效，与安慰剂相比，MODIFY1和2试验的汇总分析显示了以下结果（bezlotoxumab：129/781[16.5]安慰剂：206/773[26.6]-10.0％[95％CI-14.0至-6.0]，p<0.0001),需要治疗的数量(NNT)为10。所有其他观察性研究也显示了在预防艰难梭菌中使用贝兹洛妥单抗的阳性反应。总之,bezlotoxumab是一个很好的选择，辅助治疗标准的CDI抗生素，用于预防高危成人的rCDI。
