OVERVIEW
This free activity consists of four Lecture Presentations, a Learning Assessment, and an Evaluation form. The content of this virtual lecture is derived from a satellite symposium presented on October 5, 2007, during the 45th Infectious Diseases Society of America (IDSA) Annual Meeting. This program was not part of the official IDSA Scientific Assembly.

MEDIUM: Virtual Lecture and Podcast
LIVE RELEASE DATE: October 5, 2007
INTERNET RELEASE DATE: November 15, 2007
Continuing education credit is no longer available for this activity.

Estimated time to complete this activity: 2.25 hours

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TARGET AUDIENCE
This activity has been designed to meet the educational needs of physicians and clinical pharmacists involved in the care of patients with Clostridium difficile-associated disease (CDAD).

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ACTIVITY PURPOSE
This symposium is intended to assist physicians and pharmacists in understanding how to manage patients with CDAD.

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STATEMENT OF NEED
Since 2002, outbreaks of a new, more virulent strain of Clostridium difficile have occurred in Canada, the United States, and the United Kingdom.^1-3 More recent outbreaks have been documented in the Netherlands in 2005 and in Northern France in 2006.^4,5 This new strain is resistant to fluoroquinolones, and treatment failures with metronidazole have increased.¹ Clostridium difficile-associated disease (CDAD) ranges from mild diarrhea to pseudomembranous colitis and is associated with high relapse rates, multiple relapses, and increased morbidity and mortality.⁶ Healthcare professionals need to be aware of the importance of early diagnosis and prompt, aggressive treatment to manage this disease.

¹ Warny M, et al. Lancet. 2005;366:1079-84.
² McDonald LC, et al. N Engl J Med. 2005;353:2433-41.
³ Health Protection Agency. CDR Wkly. 2005;15:1-3.
⁴ Kuijper EJ, et al. Clin Microbiol Infect. 2006;12(Suppl 6):2-18.
⁵ Eurosurveillance Weekly Release. http://www.eurosurveillance.org/ew/2006/060126.asp#2. Accessed May 9, 2007.
⁶ Centers for Disease Control and Prevention Fact Sheet. July 2005.

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

• Describe the epidemiology of C. difficile in Europe and Canada
• Summarize the future of C. difficile epidemiology in the United States
• Identify current treatment strategies for C. difficile in the United States and Canada
• Explain C. difficile evidence-based guideline recommendations for clinical practice

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METHOD OF PARTICIPATION
There are no fees for participating and receiving CME credit for this activity. During the period of October 5, 2007 through November 15, 2008, participants must 1) read the learning objectives and faculty disclosures; 2) study the educational activity; 3) complete the post-test by recording the best answer to each question on the Learning Assessment pages; 4) complete the Evaluation form; and 5) mail, fax or electronically submit the Evaluation form to Postgraduate Institute for Medicine.

Participants must receive a score of at least 75% on the Learning Assessment and must complete and submit the Evaluation form to successfully complete this activity. Participants who successfully complete this activity will be issued a statement of credit via US mail in 4 to 6 weeks.

NOTE: Attendees of the live symposium held at the San Diego Marriott Hotel & Marina in San Diego, California, in October 2007, are not permitted to participate in this activity and cannot receive credit.

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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 2.25 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

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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 continuing education activity for 2.25 contact hours (0.225 CEU) of the Accreditation Council for Pharmacy Education. (Universal Program Number 809-999-07-147-H01-P)

A statement of credit will be issued only upon receipt of a completed activity Evaluation form and will be mailed to participants in 4 to 6 weeks. If you have received credit for UPN 809-999-07-079-L01, you are not eligible for this activity.

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FACULTY
Dale N. Gerding, MD, FIDSA
Dale N. Gerding, MD, FIDSA, is Professor of Medicine at Loyola University Chicago Stritch School of Medicine in Maywood, Illinois, and Associate Chief of Staff for Research at Hines Veterans Affairs Hospital in Hines, Illinois, in the United States.

Mark Wilcox, MD, MRCPath, BMedSci, BMBS
Mark Wilcox, MD, MRCPath, BMedSci, BMBS, is Professor of Medical Microbiology at the University of Leeds, and Head of Microbiology, Clinical Director of Pathology, and Director of Infection Prevention and Control for the Leeds Teaching Hospitals in the United Kingdom.

Mark A. Miller, MD, FRCPC, MSc
Mark A. Miller, MD, FRCPC, MSc, is Chief of the Department of Microbiology, Head of the Division of Infectious Diseases in the Department of Medicine, and Chair of the Infection Prevention and Control Committee at the SMBD Jewish Hospital in Montreal, Quebec, Canada.

Stuart Johnson, MD, DTM&H
Stuart Johnson, MD, DTM&H, is Associate Professor of Medicine at Loyola University Chicago Stritch School of Medicine in Maywood, Illinois, and Staff Physician at the Hines Veteran Affairs Hospital in Hines, Illinois, in the United States.

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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.

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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. Postgraduate Institute for Medicine (PIM), Robert Michael Educational Institute LLC and ViroPharma Incorporated do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of PIM, Robert Michael Educational Institute LLC and ViroPharma Incorporated. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings.

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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 following faculty reported a real or apparent conflict of interest:

Dr. Dale N. Gerding has asked that we advise participants in this activity that he has an affiliation with AstraZeneca, Genzyme Corporation, GOJO Industries, Inc., Optimer Pharmaceuticals, Inc., Oscient Pharmaceuticals, Romark Laboratories, LC, Salix Pharmaceuticals, Inc., and ViroPharma Incorporated (Consultant); Genzyme Corporation, GOJO Industries, Inc., Massachusetts Biological Laboratories, and ViroPharma Incorporated (Research); and ViroPharma Incorporated (Patents).

Dr. Mark Wilcox has asked that we advise participants in this activity that he has an affiliation with Genzyme Corporation, Novacta Biosystems, Nebrivn, Pfizer, Inc., Replidyne, Inc., and Wyeth Pharmaceuticals (Consult); AstraZeneca, Bayer, Pfizer, Inc., and Wyeth Pharmaceuticals (Speakers' Bureau); and Bayer, Novacta Biosystems, Nebrivn, Targanta Therapeutics, Pfizer, Inc., and Wyeth Pharmaceuticals (Research).

Dr. Mark A. Miller has no affiliations with commercial interests to disclose.

Dr. Stuart Johnson has asked that we advise participants in this activity that he has an affiliation with Acambis, Genzyme Corporation, Romark Laboratories, LC, Salix Pharmaceuticals, Inc., and ViroPharma Incorporated (Consultant).

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.

Patricia C. Walter 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.

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FEE INFORMATION
There is no fee for this educational activity.

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QUESTIONS AND 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.

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SYSTEM REQUIREMENTS
Hardware/Software requirements include:
• Windows 95, 98se, ME, XP, NT 4.0, 2000   
  - Internet Explorer 4.0+
  - Netscape Navigator 6.2+
  - 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
  - Windows Media Player
  - Internal/external speakers
  - Broadband connection (DSL/cable) recommended

 

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