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Clostridium difficile Infection: Best Strategies for Care of Older Adults

TARGET AUDIENCE
This activity has been designed to meet the educational needs of registered nurses and nurse practitioners involved in the care of patients with Clostridium difficile infection.

ACTIVITY PURPOSE
This activity is intended to assist registered nurses and nurse practitioners in understanding how to manage patients with Clostridium difficile infection.

STATEMENT OF NEED
Clostridium difficile infection (CDI) is a serious condition that represents a significant burden to the healthcare system. Mortality rates associated with CDI have increased dramatically in the past several years, and as many as 20% of patients admitted to hospitals in which Clostridium difficile-associated disease is endemic may acquire CDI.¹^,² Older adults are at an increased risk for developing CDI, particularly those who are housed in long-term care facilities.² This is largely due to age-related changes in fecal flora and host defenses, as well as the presence of multiple comorbidities.³ As CDI-associated mortality is higher in geriatric patients than in other age groups, proper treatment and management strategies are imperative.³ Healthcare providers of geriatric care should be aware of risk factors for CDI, diagnostic considerations, and treatment strategies for older adults.

¹Redelings MD, et al. Emerg Infect Dis. 2007;13:1417-1419.
²Gerding DN, et al. Infect Control Hosp Epidemiol. 1995;16:459-477.
³Crogan NL, Evans BC. Geriatr Nurs. 2007;28:161-164.

EDUCATIONAL OBJECTIVES

Cite the evolving epidemiology of C. difficile infection (CDI)
Describe factors that contribute to the risk for severe CDI in older adults
Outline special diagnostic considerations for CDI in older adults
Review treatment strategies for first episode and recurrent CDI

STATEMENT OF SUPPORT
This activity is jointly sponsored by Robert Michael Educational Institute LLC and Postgraduate Institute for Medicine, and is supported by ViroPharma Incorporated.

This continuing education monograph is certified for registered nurses and nurse practitioners.

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In order to receive 1 AMA PRA Category 1 Credit™ for completing this activity, mail or fax both completed pages of the Evaluation form to:
  Postgraduate Institute for Medicine (PIM)
  Attn: Record Keeping Department
  367 Inverness Parkway, Suite 215, Englewood, CO 80112
  Fax: (303) 790-4876

You may also complete the post-test online at www.cmeuniversity.com. Click on "Find Post-Test/Evaluation by Course" on the navigation menu, and search by project ID 6035. Upon successfully completing the post-test and evalulation, your certificate will be made available immediately.

FACULTY

	Erik R. Dubberke, MD Assistant Professor of Medicine Infectious Diseases Division Department of Medicine Washington University School of Medicine Medical Director Infection Control Missouri Baptist Medical Center St. Louis, Missouri
	Suzanne F. Bradley, MD Professor of Medicine Department of Internal Medicine Veterans Affairs Health Systems University of Michigan Medical School Ann Arbor, Michigan

CONTENTS

Clostridium difficile Infection: Best Strategies for Care of Older Adults

– Introduction
– Epidemiology and Diagnosis of Clostridium difficile Infection (CDI)
    Erik R. Dubberke, MD
– Cases and Conundrums: How to Manage Clostridium difficile in Older
    Adults
    Suzanne F. Bradley, MD
– Conclusion
– References
Learning Assessment and Evaluation Form

Release Date:
December 1, 2008
CE Available Until:
December 1, 2009