Key takeaways
Zinplava (bezlotoxumab) and metronidazole (Flagyl) are both used to address infections, but they serve different purposes and work in different ways. Zinplava is a biologic given as a single IV injection to prevent repeat infections of Clostridioides difficile (C. diff) in high-risk adults. It works by neutralizing a toxin released by the C. diff bacteria. On the other hand, metronidazole is an oral nitroimidazole antibiotic used to treat various bacterial and parasitic infections, such as C. diff, bacterial vaginosis and trichomoniasis. Metronidazole is taken multiple times a day and is available as a lower-cost generic. While Zinplava is only used for prevention and must be administered by a healthcare provider, metronidazole treats active infections, including C. diff, and comes in an oral tablet that can be taken at home. Additionally, metronidazole has a serious interaction with alcohol, which is not a concern with Zinplava. Both medications have their own sets of side effects, with Zinplava potentially causing heart failure symptoms and metronidazole posing risks of brain and nerve problems, among others.
