Updates in the Treatment and Prevention of C. difficile: Hospital Perspectives - OverView - Insights & Updates in Treatment of Prevention of C.difficile INFECTION

CME/CE information

Intended Audience

This activity is intended for gastroenterologists, infectious disease specialists, and other healthcare professionals that treat C. difficile infections.

Activity Purpose

CDI is associated with significant morbidity and mortality. Further, recurrence of CDI is common after an initial episode. Although a number of therapies with varying mechanisms of action, are available to treat CDI and prevent recurrence, the management of CDI is complex and challenging. Clinicians require up-to-date knowledge of evidence-based treatment of recurrent CDI to reduce its burden and improve clinical outcomes.

Learning Objectives

Upon completion of this curriculum, participants will be able to:
• Summarize the epidemiology of C. difficile infections in hospital settings
• Identify patients who may be at increased risk for C. difficile infection
• Discuss strategies for preventing the transmission of C. difficile in hospitalized patients
• Outline evidence-based approaches for the management of initial and recurrent episodes of C. difficile

Method of Participation

This activity will take approximately 45 minutes to complete. To receive credit, participants are required to complete the pre-test, view the online activity, and complete the post-test and evaluation forms. To receive credit, 75% must be achieved on the post-test. A certificate will be immediately available. There is no fee to participate in the activity or for the generation of the certificate.

Release date: September 5, 2017
Expiration date: September 5, 2018.

Inquiries may be directed to ACHL at (877) 444-8435, ext. 203.

Faculty Disclosure

ACHL requires that the faculty participating in a CME/CE activity disclose all affiliations or other financial relationships (1) with the manufacturers of an y commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of this activity. All conflicts of interest have been resolved prior to this CME/CE activity.

The following financial relationships have been provided:

Scott Curry, MD
Types of financial relationships: None

Carlene Muto, MD, MS
Types of financial relationships: None

Discussion of Off-Label, Investigational, or Experimental Drug/Device Use: Novel therapies under investigation for the treatment of CDI.

Accreditation and Credit Designation

The Academy for Continued Healthcare Learning (ACHL) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

ACHL designates this enduring material or a maximum of 0.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Supporter Information

This activity is supported by an educational grant from Merck & Company.

Staff Disclosure

ACHL staff members and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

Disclaimer

The content for this activity was developed independently of the commercial supporter. All materials are included with permission. The opinions expressed are those of the faculty and are not to be construed as those of the publisher or grantor.

This educational activity was planned and produced in accordance with the ACCME Accreditation Criteria, Policies, and Standards for Commercial Support. Recommendations involving clinical medicine in a continuing medical education (CME/CE) activity must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported, or used in CME/CE in support or justification of a patient care recommendation must conform to the generally accepted standards of experimental design, data collection, and analysis.

This CME/CE activity might describe the off-label, investigational, or experimental use of medications and/or devices that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers’ prescribing information for these products. ACHL requires the speaker to disclose that a product is not labeled for the use under discussion.

Program Manager

Katlyn Cooper
kcooper@achlcme.org
Phone: (586)453-1845

Resources

Clinician Resources

Cohen SH, Gerding DN, Johnson S, et al. Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the society for healthcare epidemiology of America (SHEA) and the infectious diseases society of America (IDSA). Infect Control Hosp Epidemiol. 2010;31(5):431-55. doi: 10.1086/651706.
Hota SS, Sales V, Tomlinson G, et al. Oral vancomycin followed by fecal transplantation versus tapering oral vancomycin treatment for recurrent Clostridium difficile infection: an open-label, randomized controlled trial. Clin Infect Dis. 2017;64(3):265-271. doi: 10.1093/cid/ciw731.
Hu MY, Katchar K, Kyne L, et al. Prospective derivation and validation of a clinical prediction rule for recurrent Clostridium difficile infection. Gastroenterology. 2009;136(4):1206-14.
Kelly CP, Wilcox M, Glerup H, Aboo N, Eves K, Dorr M. Characteristics and outcomes in patients with C. Difficile Infection (CDI) and inflammatory bowel disease: bezlotoxumab versus placebo. Gastroenterology. 2017;152(5):S340.
Lessa FC, Mu Y, Bamberg WM, et al. Burden of Clostridium difficile infection in the United States. N Engl J Med. 2015;372(9):825-34. doi: 10.1056/NEJMoa1408913.
Louie TJ, Miller MA, Mullane KM, et al. Fidaxomicin versus vancomycin for Clostridium difficile infection. N Engl J Med. 2011;364(5):422-31. doi: 10.1056/NEJMoa0910812.
Surawicz CM, Brandt LJ, Binion DG, et al. Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections. Am J Gastroenterol. 2013;108(4):478-98. doi: 10.1038/ajg.2013.4.
Magill SS, Edwards JR, Bamberg W, et al. Multistate point-prevalence survey of health care-associated infections. N Engl J Med. 2014 Mar 27;370(13):1198-208. doi: 10.1056/NEJMoa1306801.
Magill SS, Edwards JR, Bamberg W, et al. Multistate point-prevalence survey of health care-associated infections. N Engl J Med. 2014 Mar 27;370(13):1198-208. doi: 10.1056/NEJMoa1306801.
Stevens V, Dumyati G, Fine LS, et al. Cumulative antibiotic exposures over time and the risk of Clostridium difficile infection. Clin Infect Dis. 2011;53(1):42-8. doi: 10.1093/cid/cir301.
Zar FA, Bakkanagari SR, Moorthi KM, Davis MB. A comparison of vancomycin and metronidazole for the treatment of Clostridium difficile-associated diarrhea, stratified by disease severity. Clin Infect Dis. 2007;45(3):302-7. Epub 2007 Jun 19.

Patient Resources

American College of Gastroenterology Patient Education & Resource Center. Available at: http://patients.gi.org/topics/c-difficile-infection/
Centers for Disease Control and Prevention. Frequently Asked Questions About C. difficile. Available at: https://www.cdc.gov/hai/pdfs/cdiff/cdif_largertext.pdf
Peggy Lillis Foundation. Available at: http://peggyfoundation.org/.
The C Diff Foundation. https://cdifffoundation.org/.

Overview

Faculty

Scott Curry, MD

Carlene Muto, MD, MS

CME/CE information

Resources

Clinician Resources

Patient Resources