The C. diff Returns: The Latest Strategies to Mitigate Recurrence

Released On
December 7, 2020

Expires On
December 7, 2021

Media Type

Completion Time
75 minutes

Gastroenterology, Hospitalist, Infectious Disease, Pharmacy, Primary Care

Clostridium difficile

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Supported by an educational grant from Merck & Company.

Credit Available

  • Physicians — maximum of 1.25 AMA PRA Category 1 Credit(s)
  • Pharmacists — 1.25 Contact Hours

All other healthcare professionals completing this course will be issued a statement of participation.

Target Audience

This activity is intended for ID specialists, hospitalists, internists, pharmacists and other clinicians who care for patients at risk of gastrointestinal infection.

Program Overview

Originally presented at a virtual symposium following IDWeek™ 2020, Paul Feuerstadt, MD, Kevin W. Garey, PharmD, and Krishna Rao, MD, discuss guideline-directed prevention and treatment of recurrent Clostridioides difficile (C. diff). Other discussion topics include risk factors for C. diff recurrence as well as antimicrobial interventions to reduce recurrence and improve outcomes.

Learning Objectives

Upon completion of this activity, participants should be better able to:

  • Implement tools to identify patients who may be at increased risk for recurrent C. difficile infection
  • Outline evidence-based approaches for the management of first and second recurrences of C. difficile infection in diverse patient populations
  • Describe the role of available antimicrobial agents and biologics for treatment and prevention of recurrent C. difficile infection


Paul Feuerstadt, MD, FACG, AGAF

Gastroenterology Center of Connecticut
Assistant Clinical Professor of Medicine
Yale University School of Medicine
Hamden, CT

Kevin W. Garey, PharmD, MS

Professor and Chair
Department of Pharmacy Practice and Translational Research
University of Houston College of Pharmacy
Houston, TX

Krishna Rao, MD, MS

Assistant Professor of Internal Medicine
Department of Internal Medicine, Division of Infectious Diseases
Michigan Medicine Infectious Disease | Taubman Center
University of Michigan
Ann Arbor, MI

Accreditation Statement & Credit Designation

Physician Continuing Medical Education

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


The Academy for Continued Healthcare Learning designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Pharmacy Continuing Education

The Academy for Continued Healthcare Learning is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.


This activity has been approved for 1.25 contact hours.

ACPE Universal Activity Number 0396-0000-20-047-H01-P

Activity Types: Application

Disclosures of Conflicts of Interest

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

The following financial relationships have been provided:

Paul Feuerstadt, MD, FACG, AGAF

  • Advisory Board: Ferring/Rebiotix
  • Consulting Agreements: Ferring/Rebiotix; Seres Therapeutics; Roche Diagnostics
  • Speakers’ Bureau: Merck & Company

Kevin W. Garey, PharmD, MS

  • Consulting Agreements: Merck & Company; Summit
  • Grants/Research Support: Acurx; Merck & Company; Paratek; Summit; Tetraphase

Krishna Rao, MD, MS

  • Consulting Agreements (Occasional): Bio-K+ International, Inc.; Roche Molecular Systems, Inc.
  • Grants/Research Support: Merck & Company

Disclosure of Unlabeled Use

Discussion of Off-Label, Investigational, or Experimental Drug/Device Use: Tapered and pulsed vancomycin, fecal microbiota transplantation, RBX7455, RBX2660, SER-109, CP101, and VE303


Section 1: Introduction to C. difficile Infection – Krishna Rao, MD, MS

  • Pathophysiology
  • Epidemiology
  • Risk Factors
  • Diagnosis:
    • Differentiating C. diff from other infections
    • Single step vs. multistep testing

Section 2: Guideline-based Management of C. difficile Infection – Paul Feuerstadt, MD, FACG, AGAF

  • Treatment of Initial Infection
  • Treatment of Recurrent Infection: First and Subsequent Recurrences
  • Prevention of Recurrence

Section 3: New Therapies/Frequently Asked Questions in C. difficile Infection – Kevin W. Garey, PharmD, MS

  • Bezlotoxumab Clinical Trial Data and Potential Role(s) in Care
  • FMT
  • Most Frequently Asked Questions: Diagnosis and Management During the Pandemic

Instructions for Participation and Credit

This activity will take approximately 75 minutes to complete. To receive credit, participants are required to complete the pretest, view the online activity, and complete the posttest and evaluation. A certificate will be immediately available. There is no fee to participate in the activity or for the generation of the certificate.

Hardware and Software Requirements

  1. Active Internet connection (DSL or Cable). Dial-up connection will have constant buffering problem.
  2. Compatible with Windows PC and MAC (256 MB of RAM or higher)
  3. Activity is best viewed on Internet Explorer 9.0 or higher, Safari 5.0 or higher and Firefox 29.0 or higher
  4. Adobe Flash Player 12.0 (or higher).
  5. Adobe Reader to print certificate.
  6. Allow ActiveX controls to run on your computer: If the yellow strip appears on the top of your web browser while running the Webcast, right click on it and select Allow blocked contents to run.

Turn the Pop-up blocker off: On the Tools menu, point to Pop-up Blocker, and then click Turn Off Pop-up Blocker


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, as well as the ACPE Accreditation Standards for Continuing Pharmacy Education. Recommendations involving clinical medicine in a continuing medical education (CME/CPE) 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/CPE 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/CPE activity might describe the off-label, investigational, or experimental use of medications 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.

Contact Information

For questions, contact Melissa Stradal at