C. difficile-Recurrence Prevention — Medical Practice MCQ

Instant feedback + full explanation. One question, done properly.

HardInfectious DiseasesC. difficile-Recurrence Prevention

A 52-year-old with recurrent hospital-acquired C. difficile (third episode) has risk factors for recurrence. Which adjunctive therapy may reduce further recurrence when added to standard of care?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Bezlotoxumab single IV dose during active treatment

Bezlotoxumab is the adjunctive option. It is a monoclonal antibody against C. difficile toxin B and is given as a single intravenous infusion during active antibacterial treatment for C. difficile infection; it is not an antibiotic and is not used as monotherapy. In adults with recurrent C. difficile infection and risk factors for further recurrence, evidence reviewed by NICE shows that adding bezlotoxumab to standard-of-care antibiotics reduces recurrence compared with placebo, particularly in higher-risk groups. In UK practice, NICE recognises this clinical effect but does not recommend routine NHS offering because of cost-effectiveness; however, among the listed options it is the evidence-based adjunct that may reduce further recurrence. Prophylactic metronidazole, indefinite oral vancomycin, probiotics as sole prevention, and bismuth subsalicylate are not recommended strategies for preventing recurrent C. difficile infection.

Reference: NICE. Clostridioides difficile infection: antimicrobial prescribing (NG199), updated 2025. https://www.nice.org.uk/guidance/ng199