A multidisciplinary discussion of the C. difficile continuum of care to contrast best practices with the realities across specialties to raise the standard of patient care.
All times listed in Eastern Standard Time.
09:00 AM – 09:15 AM
Introduction and opening remarks by Steering Committee
Description: Physician’s decisions are complicated and constrained by a host of health-system-level factors beyond individual practitioners knowing and following current evidence-based best practices. To impact the overall management, quality, and experience of CDI patients, a systems view incorporating readmissions, continuum/transitions of care, infection control practices, antibiotic stewardship, quality measures, and patient experiences is necessary.
Stuart Johnson, MD, DTM&H, Loyola University Chicago Stritch School of Medicine
Stuart H. Cohen, MD, University of California Davis Health
Ronald Hsu, MD, University of California Davis School of Medicine
Description: Clinical practice guidelines have well-defined diagnostic criteria for establishing active CDI, yet many outstanding challenges remain in day-to-day practice. Following an overview of best-practice procedures, panelists and participants will discuss the variability of diagnostic procedures among specialties and practice locations to establish context-considerate recommendations.
Kevin W. Garey, PharmD, MS, University of Houston
Lynn Bry, MD, PhD, Harvard Medical School
Alice Y. Guh, MD, MPH, Centers for Disease Control and Prevention
Maribeth R. Nicholson, MD, MPH, Vanderbilt University Medical Center
Description: Despite some disagreements, clinical practice guidelines align more closely with one another than they do with the range of antibiotic practices utilized by clinicians for treating CDI. The session chair will describe best practices for the range of scenarios encountered, and the panelists will discuss the range of antibiotic types, dosages, and administration routes utilized among physicians as well as the potential reasons for the discrepancies between guidelines and practice. After an overview of uncontroversial options for initial cases, the majority of the session will focus on antibiotic and adjuvant therapeutic options for recurrent cases.
Stuart Johnson, MD, DTM&H, Loyola University Chicago Stritch School of Medicine
Carl V. Crawford, Jr., MD, New York Presbyterian Hospital – Weill Cornell Medicine
Larry Danziger, PharmD, University of Illinois at Chicago
Andrew M. Skinner, MD, George E. Wahlen VA Medical Center
Description: Fecal microbiota transplantation is now well established for the prevention of recurrent CDI. The session chair will summarize best practices for using FMT to manage CDI based on the growing body of evidence for efficacy. Panelists will discuss how FMT is utilized among specialties and the outstanding challenges hindering adoption of this management tool. Specific circumstances for continuing to prescribe FMT instead of newly approved live biotherapeutic products (LBP) will also be addressed.
Colleen Kelly, MD, Brigham and Women’s Hospital
Najwa El-Nachef, MD, University of California San Francisco
Alexander Khoruts, MD, University of Minnesota
Nirja Mehta, MD, MS, Emory University
Description: The U.S. Food and Drug Administration has approved two LBPs for the prevention of recurrent CDI. The body of evidence leading to these approvals will be summarized to establish the situations for best-practice use of the new preventative tools. Panelists will discuss current use of LBPs or their expectations for the adoption of LBPs within their specialties. The group will focus attention on situations where evidence would suggest the use of antibiotics, FMT, LBPs, or combinations thereof.
Paul Feuerstadt, MD, Yale School of Medicine
Abhishek Deshpande, MD, PhD, Case Western Reserve University
Sahil Khanna, MBBS, MS, Mayo Clinic
Mark Wilcox, B Med Sci, BM, BS, MD, University of Leeds
Description: Severe and fulminant cases of CDI pose a particular challenge because they often require coordination among specialists for their expertise. The group will consider when, why, and from whom physicians should seek support from colleagues to improve patient outcomes.
Monika Fischer, MD, MSc, Indiana University
Ari Grinspan, MD, Icahn School of Medicine at Mount Sinai
Scott Curry, MD, MS, Medical University of South Carolina
David B. Stewart, MD, Southern Illinois University
Neil Stollman, MD, Alta Bates Summit Medical Center and University of California San Francisco
PRODUCED IN CONJUNCTION WITH KNIGHTEN HEALTH