TARGET AUDIENCE
This activity has been designed to meet the educational needs of physicians and clinical pharmacists involved in the treatment of hematopoietic cell transplant (HCT) recipients.

ACTIVITY PURPOSE
This activity is intended to assist physicians and pharmacists in preventing cytomegalovirus (CMV) infection in HCT recipients and implementing therapeutic strategies that reduce CMV drug resistance.

STATEMENT OF NEED
Cytomegalovirus (CMV) is an important cause of morbidity and mortality in recipients of hematopoietic cell transplant (HCT). CMV infection occurs in up to 60% of HCT patients, and CMV disease occurs in 10% of HCT patients in the preemptive therapy era.^1,2 Immunosuppression before and after HCT causes patients to be particularly vulnerable to opportunistic infections such as CMV. The clinical manifestations of CMV disease range from gastrointestinal disease to life-threatening pneumonia, myelosuppression, retinitis, and encephalitis.
An understanding of the management of CMV, including prophylaxis and treatment, is especially important considering that many antiviral therapeutic agents have significant hematologic toxicity. Despite great progress in elucidating the pathophysiology of CMV infection and the spectrum of disease in HCT recipients, diagnostic and therapeutic challenges remain. Thus, it is clear that additional research and improved therapies are needed for this persistent pathogen.

¹Razonable RR, et al. Expert Rev Anti
  Infect Ther. 2004;2:27-41.
²Nichols WG, et al. J Clin Virol. 2000; 16:
  25-40.

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

• Identify the changing epidemiology and clinical spectrum of disease caused by C. difficile
• Describe the challenges associated with C. difficile infection in the long-term care setting
• Identify optimal therapies in the treatment of C. difficile infection in the long-term care setting
• Identify prevention and control measures that may contain the spread of CDAD

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