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CME: The difficulty with (C.) difficile: guideline updates and optimal identification and treatment strategies

Activity Description / Statement of Need:

Clostridioides difficile (formerly known as Clostridium difficile) is a gram-positive obligate anaerobe that produces exotoxins in the gastrointestinal (GI) tract resulting in watery, loose stool, abdominal pain, and nausea. The U.S. incidence of Clostridioides difficile infection (CDI) is about half a million people, with 28% community-acquired, 37% healthcare-associated, and 36% associated with long-term care facilities. Additionally, CDI has incurred one billion dollars in costs to the U.S. healthcare system. Antibiotic exposure causes changes to the GI microflora and increases the risk of developing CDI, which is especially seen in carbapenems, third-/fourth- generation cephalosporins, clindamycin, and fluoroquinolone use. Other risk factors include acid suppressive therapy; age; prolonged hospitalizations or other recent healthcare exposure; recent tube feeding or GI surgery; and immunocompromised states, including recent chemotherapy.

Target Audience:

HCPs including: infectious diseases physicians, gastroenterologists, hospitalists, and intensivists; physician assistants, nurse practitioners, and pharmacists who practice in the aforementioned areas of specialty; and any other HCPs with an interest in or who clinically encounter patients with CDI. 

This program is supported by an educational grant from Merck

This activity is free of charge.

Release Date: February 04, 2022 -- Expiration Date: February 04, 2024

Faculty: Mireya Wessolossky, MD, MPH



Faculty introduction and disclosures

CDI review

·       Epidemiology

·       Risk factors and pathophysiology

·       Clinical features and presentation

·       Burden of disease

·       Diagnostic tools

·       NAAT, GDH assay, toxin tests

Treatment of CDI

·       Treatment of CDI

o   Mild to moderate CDI

o   Severe CDI

o   Fulminant CDI

o   Recurrent CDI

·       Challenges in therapy decision-making and optimal outcomes

o   Overdiagnoses and delayed diagnoses

o   Nonadherence to CDI guidelines

·       Prevention measures

·       Best practice: putting it all together

·       Patient cases

Summary, conclusions, and best practice recap

Learning Objectives

By the end of the session the participant will be able to:

  • Describe the burden of disease on patients with CDI and the consequences of inappropriate diagnosis and treatment
  • Recall the optimal sequencing of tests in the diagnosis of CDI, and apply that information to patient cases
  • Identify present and emerging therapies and best practice in treating CDI
  • Formulate a treatment plan for a patient with CDI


ACCME Activity #201837401

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through ScientiaCME. ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.


ABIM MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Physicians: For applicable courses, to attain maintenance of certification (MOC) credit, you must enter your board certification ID # and birth date correctly.  It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC credit for this activity. Please note: not all activities on this site provide MOC credit. If this activity does not specify that it provides MOC credit in the "Accreditation" section on this page, then it does NOT provide MOC credit.


ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 1.0 contact hours (0.1 CEUs) of continuing pharmacy education credit. Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test. Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit. ACPE # 0574-0000-22-011-H01-P.  This is an Application (A)-type activity.

PharmacistsYou must enter your NABP # and birth date correctly so that proof of participation can be posted to your NABP CPE profile. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive CPE credit for this activity.

Nurse Practitioners (NPs): The American Academy of Nurse Practitioners accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.  ScientiaCME will provide NPs who successfully complete each activity with a certificate of participation indicating that the activity was designated for AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.

Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review ScientiaCME.

Faculty: Mireya Wessolossky, MD, MPH, University of Massachusetts Chan Medical School, has no relevant financial disclosures.


Faculty WILL NOT discuss off-label use of a commercial product.

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, CEO of ScientiaCME, has no relevant financial disclosures.

Commercial Support Disclosure: This program is supported by an educational grant from Merck.


  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural/Linguistic Competence & Health Disparities

System Requirements

Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version

Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.