Recurring Problems, New Solutions: Interrupting the Cycle of Recurrence in Clostridioides difficile Infection
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o View the patient cases and expanded insights to help you mitigate the risk of C. diff recurrence.
Clostridioides difficile is a Gram-positive bacteria that causes diarrhea, abdominal bloating, and colitis. As such, it is associated with significant morbidity and mortality, increased healthcare costs, and hospital readmission rates. Surveillance data indicate an overall decrease in C. difficile infections (CDI) and associated hospitalizations owing to declines in health care-associated infections. However, the number of community-associated cases has remained unchanged and the number of patients with multiple recurrent episodes has increased. As such, the Centers for Disease Control and Prevention continues to classify C. difficile as an urgent threat given the great burden on patients and the healthcare system.
A changing epidemiology, new therapies, accumulating clinical trial, and real-world data have ushered in advances in the treatment of CDI. The American College of Gastroenterology and a panel from the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America (IDSA/SHEA) both released updated clinical practice guidelines on the diagnosis, treatment, and prevention of C. difficile in 2021 to capture new data. There are important differences between these guidelines as those from IDSA/SHEA no longer recommend metronidazole for initial or recurrent episodes and overall recommend more aggressive therapy with a preference for fidaxomicin. Upon completing this activity, clinicians will become more familiar with the advances and evolving changes in the selection and application of antimicrobial therapies for treating initial and recurrent CDI.
• Discuss the selection of antimicrobials considerate of their spectrum and impact on gut microbiota
• Recognize the role of antitoxins in the prevention of recurrent CDI
• Apply available and updated clinical guidelines to ensure evidence-based therapeutic selection for treatment and prevention of recurrent CDI in diverse patient populations
• Describe clinical risk factors that increase a patient’s risk for recurrent and multiply recurrent C. difficile infection
• Employ diagnostic methods to improve recognition of CDI in both the hospital and community setting
• Diagnosis of C. diff
• C. diff Epidemiology
• Latest Antimicrobial Studies for CDI
• Guideline Recommendations for CDI
• Bezlotoxumab Data for CDI
• Combination Regimens for CDI
• Real World Questions and Considerations
• Patient Case #1: C. diff Diagnosis
• Patient Case #2: First Recurrence of C. diff
• Patient Case #3: Primary C. diff Occurrence
• Patient Case #4: Multiple C. diff Recurrences
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Assistant Clinical Professor of Medicine
Yale University School of Medicine
Gastroenterology Center of Connecticut
The Academy for Continued Healthcare Learning is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.