Recognizing, Treating, and Preventing Recurrence of Clostridium difficile Infection (CDI) in Patients With IBD

Recognizing, Treating, and Preventing Recurrence of Clostridium difficile Infection (CDI) in Patients With IBD

On-Demand Webcast

David Binion, MD, FACG
University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania


Jessica R. Allegretti, MD, MPH
Brigham and Women’s Hospital
Cambridge, Massachusetts

Kevin W. Garey, PharmD, MS
University of Houston
College of Pharmacy
Houston, Texas

Target Audience

This educational activity is designed and certified for the entire IBD healthcare team and includes education for gastroenterologists, pediatric gastroenterologists, surgeons, physicians, PhDs, researchers, pharmacists, nurse practitioners, physician assistants, gastroenterology nurses, and residents/fellows/students.


The incidence and severity of Clostridium difficile (C diff) infection (CDI) in the United States has increased in recent years, and C diff is now characterized by the CDC as 1 of 3 pathogens considered to be lethal, urgent, antibiotic-resistant threats. The management of CDI is particularly challenging among patients with inflammatory bowel disease (IBD), who may be more susceptible to infection; experience a more progressive disease course; and require more intensive clinical intervention. The burden of CDI among patients with IBD is compounded by persistent diagnostic and therapeutic challenges, as clinicians often struggle to distinguish between IBD flares and CDI symptoms and must navigate the complexity of co-treatment considerations. Moreover, CDI recurrence is common in patients with IBD, generating unique considerations for mitigating the risk of recurrent infection and treating those instances that do occur.

In addition to traditional antibiotic approaches, treatments with alternative mechanisms of action such as antibody targeting of C diff toxin B are now available, with recent data demonstrating the benefit of the latter in preventing CDI recurrence in patients who are at a high risk. Guideline recommendations are available to inform the selection, intensification, and sequencing of available therapeutic approaches for initial or recurrent CDI in patients with IBD, which must be coupled with a shared decision-making approach that supports patient self-care to ensure optimal co-treatment. Thus, IBD specialists and other gastroenterology professionals require targeted education to overcome current diagnostic and therapeutic challenges in the management of CDI in patients with IBD, and to ensure the adoption of evidence-based co-treatment strategies that result in optimal outcomes with both conditions.


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

  1. Recognize the differential prevalence and impact of CDI among patients with IBD
  2. Address barriers to the timely identification and optimal co-treatment of CDI and IBD in affected patients
  3. Integrate the latest evidence into strategies for the effective treatment of initial and recurrent CDI in patients with IBD

Release Date: February 14, 2020

Expiration Date: February 14, 2021

Hardware/Software Requirements

The evaluation is accessible after the activity via a PC (Windows 7 or newer) or Mac (Mac OS 10.6 or later) computer with current versions of the following browsers: Internet Explorer, Mozilla Firefox, Google Chrome, or Safari. A PDF reader is required for print publications. Please direct technical questions to


This symposium is supported by an educational grant from Merck Sharp & Dohme Corp.


 In support of improving patient care, this activity has been planned and implemented by North American Center for Continuing Medical Education (NACCME) and Imedex. NACCME is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team. 


NACCME designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit™.

Physicians should claim only the credit commensurate with the extent of their participation in the activity.


NACCME has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with the AAPA CME Criteria. This activity is designated for 1.0 AAPA Category 1 credit(s).

PAs should only claim credit commensurate with the extent of their participation.


This continuing nursing education activity awards 1.0 contact hour.

Provider approved by the California Board of Registered Nursing, Provider #13255 for 1.0 contact hour.


This knowledge-based activity (JA0006201-9999-20-089-H01-P) is approved for 1.0 contact hour (0.1 CEU) of continuing pharmacy education.

ACPE Credit Policy

Your official record of ACPE credit will be generated through the CPE Monitor System. The certificate printed from this website after completing the evaluation for this activity is for personal tracking purposes only.

Eligibility for pharmacy credit is contingent upon the successful completion of a post-test and/or evaluation for each activity or session attended. Please note that you must complete the activity evaluation within 60 days of a live activity or within 60 days of beginning the evaluation for an enduring activity. Under ACPE Policy, NACCME will not be able to report your activity completion to CPE Monitor after this 60-day period.

Any participant wanting to file a grievance with respect to any aspect of a continuing pharmacy education activity accredited by NACCME may contact the Manager, Accreditation & Compliance, NACCME, in writing at 104 Windsor Center Drive, East Windsor, NJ 08520. The Manager, Accreditation & Compliance will review the grievance and respond within 30 days of receiving the written statement. If the participant is unsatisfied with the response, an appeal to the Senior Director, Accreditation and Compliance, NACCME, may be made for a second level of review.

Planning Committee

The planning committee comprises David Binion, MD, FACG, Jessica R. Allegretti, MD, MPH, Kevin W. Garey, PharmD, MS; and Chris Bolwell, and Lara Gray, Imedex.

Financial Disclosure and Conflicts of Interest

According to the disclosure policy of NACCME and Imedex, faculty, editors, managers, and other individuals who are in a position to control content are required to disclose any relevant financial relationships with relevant commercial companies related to this activity. All relevant financial relationships that are identified are reviewed for potential conflicts of interest. If a conflict is identified, it is the responsibility of NACCME and Imedex to initiate a mechanism to resolve any conflicts. The existence of these interests or relationships is not viewed as implying bias or decreasing the value of the presentation.

All educational materials are reviewed for fair balance, scientific objectivity of studies reported, and levels of evidence.

Jessica R. Allegretti, MD, MPH reports that she is a consultant for Takeda, Janssen, Pfizer, Merck, and Finch Therapeutics; and has received grant or research support from Merck.

David Binion, MD, FACG reports that he is a speaker for Janssan Biotech and Abbvie

Kevin W. Garey, PharmD, MS reports that he has received grant or research support from Merck and Co.

Chris Bolwell discloses that he holds shares of stock of GlaxoSmithKline.

Lara Gray disclosed no relevant financial relationships with any commercial interests.


This activity may contain information about experimental and other uses of drugs or devices that are not currently approved by the European Medicines Agency (EMA) of the European Union or the Food and Drug Administration (FDA) of the United States. Participants are strongly encouraged to consult approved product labeling for any drug or device mentioned in this activity before use. The opinions expressed during this activity are the opinions of the respective authors, presenters or moderators and do not necessarily reflect the opinions of NACCME or Imedex.

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NACCME and Imedex protect the privacy of personal and other information regarding participants, educational partners, and joint providers. NACCME, Imedex and our joint providers will not release personally identifiable information to a third party without the individual's consent, except such information as is required for reporting purposes to the appropriate accrediting agency.

NACCME and Imedex maintain physical, electronic, and procedural safeguards that comply with federal regulations to guard your nonpublic personal information.

Copyright © 2019 by North American Center for Continuing Medical Education, LLC. All rights reserved. No part of this accredited continuing education activity may be reproduced or transmitted in any form or by any means, electronic or mechanical, without first obtaining permission from North American Center for Continuing Medical Education. The opinions expressed in this educational activity are those of the faculty and are not attributable to NACCME. Clinical judgment must guide each professional in weighing the benefits of treatment against the risk of toxicity. Dosages, indications, and methods of use for products referred to in this activity are not necessarily the same as indicated in the package insert for each product, may reflect the clinical experience of the presenters, and may be derived from the professional literature or other clinical sources. Consult complete prescribing information before administering.