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A Gut Check: Altering the GI Microbiome to Fight the <em>C diff</em> Invasion—Case 2: A 77-Year-Old Male Patient With a History of Multiple Chronic Diseases Develops Diarrhea

A Gut Check: Altering the GI Microbiome to Fight the C diff Invasion—Case 2: A 77-Year-Old Male Patient With a History of Multiple Chronic Diseases Develops Diarrhea

Format

Patient Case Study

Time to Complete

30 minutes

Released

October 25, 2019

Expires

October 25, 2020
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Maximum Credits

0.50 / AMA PRA Category 1 Credit(s)TM

Accredited Provider


Provided by The American Gastroenterological Association (AGA)

Commercial Supporter

This activity is supported by educational funding provided by Merck & Co., Inc.

Producer


Produced by Haymarket Medical Education (HME)

Program Description

A number of factors are known to increase the risk of developing Clostridioides difficile (C diff) infection (CDI); these include certain medications, chronic conditions, and gastrointestinal procedures. However, the major risk factors for CDI are antibiotic use, hospitalization, and advanced age. By recognizing patients’ risk factors for C diff, clinicians can triage appropriate therapies to minimize risk and potentially avoid the infection.

Part of a larger myCME™ initiative on optimizing the management of patients with C diff, this case study centers on best practices for an elderly male resident of a long-term-care facility who has a history of multiple chronic illnesses; the patient was recently seen in the emergency department for evaluation of severe diarrhea. Evidence-based approaches to screening this patient for CDI are reviewed, as are initial approaches to antibiotic therapy. As the judicious use of antibiotics is a key component of preventing initial and recurrent CDI, updated guidance from Infectious Diseases Society of America and Society for Healthcare Epidemiology of America relative to effective antibiotic stewardship are reviewed in detail.

Intended Audience

Gastroenterologists, infectious disease specialists, hospitalists, and primary care clinicians (MDs/DOs, nurse practitioners [NPs], and physician assistants [PAs])

Educational Objectives

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

  • Identify individuals at risk for developing Clostridioides difficile infection (CDI)
  • Utilize updated, evidence-based strategies for treating initial CDI

Conflict Of Interest Disclosure Policies

In accordance with the ACCME’s Standards for Commercial Support of Continuing Medical Education, all faculty and planning partners must disclose any financial relationship(s) or other relationship(s) held within the past 12 months. The AGA Institute will implement mechanisms to identify and resolve all conflicts of interest prior to delivering the educational activity to learners.

Faculty

Paul Feuerstadt MD, FACG, AGAF
Assistant Clinical Professor of Medicine
Yale University School of Medicine
Attending Gastroenterologist
Gastroenterology Center of Connecticut
New Haven, CT

Dr. Feuerstadt is on the speakers' bureau for Merck & Co., Inc., and is a consultant for Ferring Pharmaceuticals and Roche Diagnostics.

Accredited Provider Disclosures

The AGA Institute and HME staff involved in the planning and content review of this activity have no relevant financial relationships to disclose.

Credit

0.50

Type

AMA PRA Category 1 Credit(s)TM

Accreditation Statement

The AGA Institute is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement

The AGA Institute designates this enduring material for a maximum of 0.50 AMA PRA Category 1 CreditTM .  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Additional Credit Information

Physician Assistant Continuing Education
AAPA accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM   from organizations accredited by ACCME or a recognized state medical society. PAs may receive a maximum of 0.50 Category 1 Credit for completing this activity.

Nurse Practitioner Continuing Education
AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM   from organizations accredited by ACCME. Individuals are responsible for checking with the AANPCP for further guidelines.

Disclosure of Unlabeled Use

This educational activity may contain discussion of approved and/or investigational uses of agents that are not indicated by the FDA. AGA, Merck & Co., Inc., and HME do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the AGA, Merck & Co., Inc., or HME. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patients' conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

If you have any questions relating to the accreditation of this activity, please contact the AGA Institute education@gastro.org.

If you have any questions relating to your certificate or other issues with the activity, please contact
myCME.Support@haymarketmedical.com.

Instructions

To obtain credit, a score of 70% or better on the post-test is required. This activity is offered at no cost to participants. Please proceed with the activity until you have successfully completed this program, answered all test questions, completed the post-test and evaluation, and have received a digital copy of your credit certificate. Your online certificate will be saved on myCME within your Profile/CME History, which you can access at any time.

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