Return to CME/CE Activities

Clostridium difficile Infections: Diagnosis, Treatment, and Prevention

• CME Information
• Faculty Biographies & Disclosures
• References
• Course Presentations
• CME Posttest

CME Information

Course Overview Educational Objectives Target Audience Method of Participation

Accreditation Statement Term of Approval Peer Review Program Director

Disclaimer Disclosure Acknowledgement of Support

Course Overview

Clostridium difficile infections (CDIs) are a growing health care problem in hospital, outpatient, and long-term care facilities. In 2005, approximately 250,000 hospitalizations were associated with CDI. While culturing and testing for toxin remains the gold standard for diagnosing CDI, the demands for rapid results have led many laboratories to rely on immunoassays that detect the presence of toxins in stool samples and, more recently, genetic tests that detect toxin-related genes. The effectiveness of these various tests has not previously been reviewed. FDA-approved antibiotics for the treatment of CDI include oral vancomycin and fidaxomicin. However, concerns about antibiotic overuse, increasing pathogen resistance, and cost have led to the use of other antibiotics such as metronidazole to treat mild-to-moderate CDI. Metronidazole and vancomycin are the two most commonly used treatments, but they are ineffective in 8 to 36 percent of patients with primary CDIs, and there are no antibiotics that kill C. difficile spores. Also, relapse or recurrence occurs in 20 to 25 percent of patients. For these reasons, there is interest in the comparative effectiveness of current antibiotic treatments for CDI, the use of nonstandard interventions for multiple recurrences, and prevention strategies.

Educational Objectives

At the conclusion of this activity, the participant should be able to:

• Apply the diagnostic tests associated with the strongest levels of evidence to diagnosing toxigenic C. difficile infections.
• Implement prevention strategies that have shown to be the most effective at reducing the incidence and transmission of toxigenic C. difficile organisms.
• Employ the most effective treatment strategies for adult patients with CDI, which may involve standard antibiotic therapy with or without nonstandard adjunctive therapy.

Target Audience

This CME activity is designed to meet the educational needs of primary care, internal medicine, infectious disease physicians, as well as other healthcare professionals who treat patients with Clostridium difficile infections.

Method of Participation

This activity is in PowerPoint file format and is accompanied by talking points and references linked to PubMed abstracts.

To receive a maximum of 1.0 AMA PRA Category 1 Credit(s)™ you should:

• View the presentations in this enduring material.
• Complete the posttest (you must answer 8 out of 10 questions correctly).
• Complete and submit the CME registration and evaluation forms.

The estimated time to complete this activity, including review of the materials, is 1.0 hour(s).

Hardware/software requirements: Activities should be run with recent versions of common browsers, including Internet Explorer, Firefox, and Google Chrome.

If you have questions about the participation process, please e-mail the Office of Continuing Medical Education, cme@bcm.edu or phone 713.798.8237.

Accreditation/Credit Designation

Baylor College of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Baylor College of Medicine designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.    

Term of Approval

December 2011 through December 2014. Original release date: December 2011

Peer Review

In December 2011,  this continuing medical education online enduring material was reviewed by Major W. Bradshaw, MD, Professor of Medicine, Baylor College of Medicine, Houston, Texas. To ensure the continued scientific relevance of this enduring material, its content will be reviewed again in December 2014.

Disclosures:  Nothing to disclose.

Program Director

Michael Fordis, MD
Sr. Associate Dean
Director, Center for Collaborative and Interactive Technologies
Director, John M. Eisenberg Center for Clinical Decisions and Communications Science
Baylor College of Medicine
Houston, Texas

Disclosures: Nothing to disclose.

Disclaimer

This CME activity is designed for use by healthcare professionals for educational purposes only. Information and opinion offered by the contributors represent their viewpoints. Conclusions drawn by the participant should be derived from careful consideration of all available scientific information. Prescription information and use of medical devices should be undertaken only after confirmation of information by consulting the FDA-approved uses and information.

Baylor College of Medicine makes every effort to have accurate information presented, no warranty, expressed or implied, is offered. The participant should use his/her clinical judgment, knowledge, experience, and diagnostic decision-making before applying any information, whether provided here or by others, for any professional use.

Links are provided to other Internet sites solely for the convenience of users. Once you link to another site, you are subject to the site's terms and conditions of use including copyright and licensing restrictions.

Disclosure

The Office of Continuing Medical Education (OCME) makes every effort to develop CME activities that are scientifically based, accurate, current, and objectively presented. In accordance with the Accreditation Council for Continuing Medical Education Standards for Commercial Support ^SM, Baylor College of Medicine (BCM) has implemented a mechanism requiring everyone in a position to control the content of an educational activity (e.g., directors, planning committee members, contributors, peer reviewers) to disclose any relevant financial relationships with commercial interests (drug/device companies) and manage/resolve any conflicts of interest prior to the activity. Individuals must disclose to participants the existence or non-existence of financial relationships: l) at the time of the activity or within 12 months prior; and 2) of their spouses/partners.

Baylor College of Medicine does not view the existence of interests or relationships with commercial entities as implying bias or decreasing the value of a presentation. It is up to the participants to determine whether the interests or relationships influence the presenter with regard to exposition or conclusions.

If at any time during this activity you feel that there has been commercial or promotional bias, please inform us by using the commercial bias comments box in the evaluation form. Please answer the questions about balance in the CME activity evaluation candidly.

The following individual(s) has/have reported no financial or other relationships with commercial entities whose products/services may relate to the educational content of this activity:

Major W. Bradshaw, MD, Peer Reviewer: Nothing to disclose.
Mary E. Butler, PhD, Contributor: Nothing to disclose.
Michael Fordis, MD, Activity Director: Nothing to disclose.
Thomas P. Giordano, MD, MPH, Contributor: Nothing to disclose.
Andrea D. Humphries, PhD, Medical Writer: Nothing to disclose.

Some drugs/devices identified during this activity may have United States Food and Drug Administration (FDA) clearance for specific purposes only or for use in restricted research settings. The FDA has stated that it is the responsibility of the individual physician to determine the FDA status of each drug or device that he/she wishes to use in clinical practice and to use the products in compliance with the applicable law.

Baylor College of Medicine requires that all contributors disclose an unlabeled use or investigational use (not yet approved for any purpose) of pharmaceutical and medical device products, and provide adequate scientific and clinical justification for such use. Physicians are urged to fully review all the available data on products or procedures before using them to treat patients.

Acknowledgement of Support

This CME activity is supported by a contract, HHSA290200810015C, from the Agency for Healthcare Research and Quality.

Return to Top of Page