Clostridioides difficile infections (CDIs), and particularly recurrent infections, cause a significant burden on the health-care system. Bezlotoxumab is a new agent for the prevention of recurrent CDIs that has shown strong efficacy and high tolerability in clinical trials. The purpose of this review is to evaluate the published literature for bezlotoxumab, with a focus on literature published since the release of the 2021 focused update to the CDI treatment guidelines. A Medline/PubMed search for “bezlotoxumab” was conducted, resulting in 152 articles. Seventeen studies are included in this review, after excluding non-English-language papers, phase I and II trials, and review articles. Studies published since the 2021 focused update support the recommendations in those guidelines. Furthermore, real-world studies have shown similar results to larger clinical trials. Those with more risk factors for recurrent CDI appear to benefit most from bezlotoxumab. Currently, there are no data to support the use of bezlotoxumab outside current guideline recommendations, but future trials may build on the data seen in real-world studies to further elucidate the place in therapy for bezlotoxumab.

Antimicrobial resistance (AMR) is a significant global health threat, with increasing morbidity, mortality, and economic consequences. Human and animal health are linked in the spread and evolution of AMR, particularly due to shared antimicrobial usage in healthcare and agriculture. This study investigates the temporal trends in AMR in both a human and an animal hospital within the same community, focusing on five common drug-bug combinations that overlap between these settings. We aim to explore whether AMR patterns in these two hospitals follow similar trajectories, potentially supporting the hypothesis of cross-species transmission of AMR. Data were retrospectively collected from 2010 to 2022 from East Alabama Medical Center (EAMC) and from 2010 to 2023 from Auburn University Veterinary Teaching Hospital (AUVTH). The analysis focused on Escherichia coli and Klebsiella pneumoniae resistance to cefazolin, ceftriaxone, levofloxacin, and gentamicin, as these were overlapping pairs that had shown statistically significant time trends in preanalysis screening. Bayesian logistic regression was applied to model trends in AMR over time. Generally, the AMR trends in the two hospitals did not align, with decreasing susceptibility in the human hospital and increasing susceptibility in the animal hospital. The trends over time for K. pneumoniae susceptibility to gentamicin were the exception, with both the human and animal hospital showing little change over time. Sensitivity analysis that excluded repeated animal isolates revealed stronger alignment between settings in resistance trends, particularly a decreasing sensitivity over time for E. coli and ceftriaxone. This finding suggests possible shared environmental factors or interspecies transmission in certain instances. This study emphasizes the need to collect combined data from humans and animals to better understand AMR and create joint efforts for antimicrobial stewardship. Further research is needed to clarify the relationship between AMR in these interconnected environments and inform strategies to mitigate the spread of resistance.

This retrospective observational study evaluates Alabama’s Coronavirus Disease 2019 (COVID-19) vaccine distribution plan and examines potential socioeconomic disparities of the distribution.COVID-19 vaccine distribution data from December 15, 2020, to March 25, 2022, obtained from the Alabama Department of Public Health (ADPH) were analyzed for 67 Alabama counties. Associations between county characteristics and vaccine distribution were assessed using Pearson correlations and linear models.Population size, number of hospitals, and number of nursing homes per county correlated significantly with vaccine distribution (p< .0001). Population size consistently influenced vaccine distribution across quarters. County Social Vulnerability Index (SVI) showed no significant association with vaccine doses per quarter. Alabama’s vaccine distribution aligned with national priorities, emphasizing healthcare personnel and adults over the age of 65. SVI did not significantly affect vaccine distribution, indicating equitable distribution across socioeconomic groups.