OVERVIEW
This free activity, entitled “Clostridium difficile Infection: Current Challenges and Controversies,” consists of four presentations and panel discussions, a Learning Assessment, and an Evaluation form. The content of this virtual lecture is derived from a symposium presented on October 25, 2008, during the 2008 ICAAC/IDSA Joint Meeting.

MEDIUM: Virtual Lecture and Podcast
INTERNET RELEASE DATE: December 15, 2008
ACPE RELEASE DATE: October 25, 2008
(Continuing education credit is no longer available for this activity.)

Estimated time to complete this activity: 2.75 hours

TARGET AUDIENCE
This activity has been designed to meet the educational needs of infectious disease physicians, microbiologists, pharmacists, nurses, and other infectious disease specialists involved in the care of patients with Clostridium difficile infection.

ACTIVITY PURPOSE
This activity is intended to assist physicians, pharmacists, nurses, and other infectious disease specialists in understanding how to manage patients with Clostridium difficile infection.

STATEMENT OF NEED
The epidemiology of Clostridium difficile infection (CDI) is changing and has been marked by increasing rates; more severe and complicated disease, particularly in elderly patients; and diminishing responses to standard therapies. Furthermore, the epidemic strain continues to be reported in an expanding list of states across the United States, and worldwide. A twofold need for education exists. First, healthcare professionals must be educated about the epidemic strain of Clostridium difficile, which appears to be more resistant to fluoroquinolones and has the ability to produce greater quantities of toxins A and B. The risk factors for CDI need to be understood, along with the decreasing efficacy, increasing rates of relapse, and high risk of recurrence associated with standard therapies for CDI. Healthcare professionals must also be informed about the importance of early recognition and prompt initiation of therapy, the preferred strategy for diagnosis, recognition of markers of severe disease, appropriate therapies based on disease severity, management of severe and recurrent disease, and effective prevention and control measures. Second, healthcare professionals must be made aware of guidelines for management of CDI that address many of these issues.

EDUCATIONAL OBJECTIVES
After completing this activity, the participant should be better able to:

• Cite challenges associated with increasing incidence and severity of C. difficile infection (CDI)
• Describe the risk for CDI associated with antimicrobial exposure
• Identify advantages and disadvantages of current diagnostic techniques for CDI
• Outline optimal treatment strategies for patients with severe and recurrent CDI

METHOD OF PARTICIPATION
There are no fees for participating and receiving CME credit for this activity. During the period December 15, 2008, through December 15, 2009, participants must 1) read the learning objectives and faculty disclosures; 2) study the educational activity; 3) complete the Learning Assessment by recording the best answer to each question in the "Learning Assessment Answers" box on the Evaluation form; 4) complete the Evaluation form; and 5) mail or fax the Evaluation form with the Learning Assessment answers to Postgraduate Institute for Medicine. You may also complete the Learning Assessment online at www.cmeuniversity.com. Click on "Find Post-Test/Evaluation by Course" on the navigation menu, and search by Project ID 5757.

Participants must receive a score of at least 70% on the Learning Assessment and must complete and submit the Evaluation form to successfully complete this activity. Participants who successfully complete the Learning Assessment and Evaluation form via www.cmeuniversity.com will have a statement of credit made available immediately. Participants who successfully complete this activity and submit the Learning Assessment and Evaluation form via fax or mail will be issued a statement of credit via US mail in 4 to 6 weeks.

PHYSICIAN CONTINUING EDUCATION
ACCREDITATION STATEMENT
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Postgraduate Institute for Medicine (PIM) and Robert Michael Educational Institute LLC (RMEI). PIM is accredited by the ACCME to provide continuing medical education for physicians.

CREDIT DESIGNATION
Postgraduate Institute for Medicine designates this educational activity for a maximum of 2.75 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

PHARMACIST CONTINUING EDUCATION
ACCREDITATION STATEMENT
Postgraduate Institute for Medicine is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.


CREDIT DESIGNATION
Postgraduate Institute for Medicine designates this educational activity for a maximum of 2.7 contact hours (0.27 CEUs) of the Accreditation Council for Pharmacy Education. (Universal Program Number - 809-999-08-236-H01-P) If you have received credit for UPN 809-999-08-072-L01-P, you are not eligible for this activity.

A statement of credit will be issued only upon receipt of the completed activity Evaluation form and will be mailed to you within 3 weeks.

NURSING CONTINUING EDUCATION
CNA/ANCC
This educational activity for 2.7 contact hours is provided by Postgraduate Institute for Medicine (PIM).

PIM is an approved provider of continuing education by the Colorado Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation.

CALIFORNIA BOARD OF REGISTERED NURSING
Postgraduate Institute for Medicine (PIM) is approved by the California Board of Registered Nursing, Provider Number 13485 for 3.3 contact hours.

FACULTY
Dale N. Gerding, MD, FACP, FIDSA
(Chairperson and Moderator)
Professor of Medicine
Loyola University Chicago
Stritch School of Medicine
Maywood, Illinois
Associate Chief of Staff for Research and Development
Hines Veterans Affairs Hospital
Hines, Illinois

Stuart H. Cohen, MD, FACP, FIDSA
Professor of Medicine
Division of Infectious Diseases
University of California, Davis School of Medicine
Clinical Director
Epidemiology and Infection Control
University of California, Davis Medical Center
Sacramento, California

Ciarán P. Kelly, MD
Associate Professor of Medicine
Harvard Medical School
Director, Gastroenterology Fellowship Training
Beth Israel Deaconess Medical Center
Boston, Massachusetts

Stuart Johnson, MD, DTM&H
Associate Professor of Medicine
Loyola University Medical Center
Stritch School of Medicine
Maywood, Illinois
Staff Physician
Hines Veterans Affairs Hospital
Hines, Illinois

Carlene A. Muto, MD, MS
Medical Director
Department of Hospital Epidemiology and Infection Control
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania

DISCLOSURE OF CONFLICTS OF INTEREST
Postgraduate Institute for Medicine (PIM) assesses conflict of interest with its instructors, planners, managers and other individuals who are in a position to control the content of CME activities. All relevant conflicts of interest that are identified are thoroughly vetted by PIM for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. PIM is committed to providing its learners with high-quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CE activity:

• Dr. Dale N. Gerding has affiliations with Optimer Pharmaceuticals, Inc.; Genzyme Corporation; Romark Laboratories, L.C.; GOJO Industries, Inc.; Oscient Pharmaceuticals; AstraZeneca; Salix Pharmaceuticals, Inc.; and ViroPharma Incorporated (Consultant); Genzyme Corporation; GOJO Industries, Inc.; ViroPharma Incorporated; and Massachusetts Biologic Laboratories (Research); and ViroPharma Incorporated (Patents).
• Dr. Stuart H. Cohen has no affiliations with commercial interests to disclose.
• Dr. Ciarán P. Kelly has affiliations with Acambis; Actelion; BioHelix; Genzyme Corporation; Replidyne; Salix Pharmaceuticals, Inc.; and ViroPharma Incorporated (Consultant and Scientific Advisor); and Actelion and Genzyme Corporation (Research Grant Support).
• Dr. Stuart Johnson has affiliations with Acambis; Genzyme Corporation; ViroPharma Incorporated; Romark Laboratories, L.C.; and Salix Pharmaceuticals, Inc. (Consultant); and Salix Pharmaceuticals, Inc. (Research).
• Dr. Carlene A. Muto has an affiliation with ViroPharma Incorporated (Speaker).

The following planners and managers have the following to disclose:

Robert Michael Educational Institute LLC

• Sherri Kramer, MD, has no affiliations with commercial interests to disclose.

Postgraduate Institute for Medicine

• Jan Hixon, RN, BSN, MS, has no affiliations with commercial interests to disclose.
• Linda Graham, RN, has no affiliations with commercial interests to disclose.
• Trace Hutchison, PharmD, has no affiliations with commercial interests to disclose.

DISCLOSURE OF UNLABELED USE
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. PIM, Robert Michael Educational Institute LLC (RMEI) and ViroPharma Incorporated 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 PIM, RMEI, or ViroPharma Incorporated. 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 patient's conditions and possible contraindications on dangers in use, review of any applicable manufacturer's product information and comparison with recommendations of other authorities.

FEE INFORMATION
There is no fee for this educational activity.

QUESTIONS & TECHNICAL ASSISTANCE
For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity: jjones@pimed.com. For technical assistance, contact jungsen@rmcom.net.

SYSTEM REQUIREMENTS
Hardware/Software requirements include:
• Windows 95, 98se, ME, XP, NT 4.0, 2000   
  - Internet Explorer 4.0+
  - Netscape Navigator 6.2+
  - AOL 8
  - Mozilla Firefox 1.0+
• Macintosh 9.2, OS X 10.1+
  - Safari 1.1+
  - Netscape Navigator 6.2+
  - Internet Explorer 5.2+
  - Mozilla Firefox 1.0+
• Additional Requirements
  - Macromedia Flash Player 7
  - Internal/external speakers
  - Broadband connection (DSL/cable) recommended

To see additional educational programming available from Robert Michael Educational Institute LLC,
visit www.RMEI.com.

PIM Privacy Policy        RMEI Privacy Statement