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Considerations for Antimicrobial Selection in Clostridioides difficile Infection

Sponsored by

This program is developed by ACHL in collaboration with MAD-ID.

Supported by an educational grant from Merck & Co., Inc.


Paul Feuerstadt, MD, FACG, AGAF

Gastroenterology Center of Connecticut
Assistant Clinical Professor of Medicine
Yale University School of Medicine
Hamden, CT

Kevin W. Garey, PharmD, MS

Professor and Chair
University of Houston College of Pharmacy
Houston, TX


The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. All conflicts of interest have been mitigated prior to this activity.

The following financial relationships have been provided:

Paul Feuerstadt, MD, FACG, AGAF
Consulting Agreements: Ferring Pharmaceuticals, Inc., Roche Diagnostics, SERES Therapeutics, Takeda Pharmaceuticals
Speakers' Bureau: Merck and Company

Discussion of Off-Label, Investigational, or Experimental Drug/Device Use: Investigational approaches to treating C. difficile infection and reducing recurrent episodes

Kevin W. Garey, PharmD, MS
Sources of Funding for Research: Acurx Pharmaceuticals, Paratek Pharmaceuticals, Inc., Summit Pharmaceuticals International, Tetraphase Pharmaceuticals, Inc. 

Consulting Agreements: Merck and Company, Summit Pharmaceuticals International  

Discussion of Off-Label, Investigational, or Experimental Drug/Device Use: Investigational approaches to treating C. difficile infection and reducing recurrent episodes


acpeThe Academy for Continued Healthcare Learning is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
This activity has been approved for 1.25 contact hours.

ACPE Universal Activity Number: 0396-0000-21-053-H01-P
Activity Type(s): Application

Release Date

November 12, 2021

Expiration Date

November 12, 2022


This activity is intended for health-system pharmacists, ID pharmacists, and other clinicians who care for patients with initial and recurrent Clostridioides difficile infections.


This activity will take approximately 75 minutes to complete. To receive credit, participants are required to complete the pretest, view the online activity and complete the posttest and evaluation. To receive credit, 80% must be achieved on the posttest. A certificate will be immediately available. There is no fee to participate in the activity or for the generation of the certificate.

For questions, contact Karen Catino at kcatino@achlcme.org 


This educational program is designed for infectious disease pharmacists interested in the treatment of CDI.  Dr. Paul Feuerstadt and Dr. Kevin Garey discuss community and healthcare-associated infections, recent updates to guidelines, and evidence-based selection of antimicrobial therapy for the treatment of initial infection and prevention of recurrence.  What happens if the patient returns with recurrence? Watch to find out as the faculty discuss a patient case highlighting the risks of recurrence and selection of therapy.


Clostridioides difficile is associated with significant morbidity and mortality, increased healthcare costs, and hospital readmission rates. As such, the Centers for Disease Control and Prevention continues to classify C. difficile as an urgent threat given the great burden on patients and the healthcare system.

A changing epidemiology, new therapies, accumulating clinical trial, and real-world data have ushered in advances in the treatment of C. difficile, prompting changes in guidelines recommendations for the selection of antimicrobial therapy. Pharmacists may not be familiar with advances and evolving changes in the selection and application of antimicrobial therapies for treating initial and recurrent CDI.


As a result of participating in this educational activity, clinicians should be able to:

  • Discuss the selection of antimicrobials considerate of their impact on gut microbiota
  • Interpret data on the role of antitoxins in the prevention of recurrent CDI
  • Assess available and updated clinical guidelines to ensure evidence-based therapeutic selection for treatment of initial infection and prevention of recurrent CDI
  • Describe clinical risk factors that increase a patient’s risk for recurrent and multiply recurrent C. difficile infection


  • Welcome and Introductions
  • C. difficile: A Continued Threat (Kevin W. Garey, PharmD, MS)
  • The Evolution of Therapy for C. difficile: What’s the Evidence? (Paul Feuerstadt, MD, FACG, AGAF)
  • Panel discussion (Dr. Garey and Dr. Feuerstadt)
  • Questions and Answers (Dr. Garey and Dr. Feuerstadt)


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All content for this activity was developed independently of the commercial supporter. All materials are included with permission. The opinions expressed are those of the faculty and are not to be construed as those of the publisher or grantor.

This educational activity was planned and produced in accordance with ACPE Accreditation Standards for Continuing Pharmacy Education. Recommendations involving clinical medicine in a continuing medical education (CME/CE) activity must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported, or used in CME/CE in support or justification of a patient care recommendation must conform to the generally accepted standards of experimental design, data collection, and analysis.

This CME/CE activity might describe the off-label, investigational, or experimental use of medications that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers’ prescribing information for these products. ACHL requires the speaker to disclose that a product is not labeled for the use under discussion.