Breakpoints

#34 – The New Scoop on Poop: Updates in the Management of C. difficile infections

Listen Later

Dr. Kevin Garey (@GareyKgarey), Dr. Kelly Reveles (@KellyReveles), Dr. Mandelin Cooper, and host Dr. Rachel Britt (@RachelBPharmD) discuss proposed updates of the IDSA-SHEA C. difficile guidelines, including: fidaxomicin over oral vancomycin as first-line therapy, the roles and logistical hurdles of fecal microbiota transplant, bezlotoxumab, and the pros and cons of prophylaxis.

Timestamps

1:16 - Panel introductions

3:19 - Fidaxomicin vs PO vancomycin for first occurrence
7:21 - Fidaxomicin cost effectiveness
11:26 - Factors to consider for health systems when considering switch to fidaxomicin
14:23 - Fidaxomicin vs PO vancomycin for recurrences
17:52 - Role of pulsed and tapered PO vancomycin
19:57 - Role of fecal microbiota transplant (FMT)
22:24 - Challenges of FMT and where pharmacy fits in
27:27 - Bezlotoxumab
31:54 - Feasibility issues with bezlotoxumab and strategies to address them
35:25 - CDI prophylaxis
40:28 - Stewardship's role in reducing C. difficile infections

References

Fidaxomicin Cost-effectiveness

  • Reveles KR, et al. Pharmacotherapy. 2017;37(12):1489-97.
  • Watt M, et al. Infection. 2016;44(5):599-606.
  • Cornely OA, et al. J Antimicrob Chemother. 2018;73(9):2529-39.
  • Rubio-Terres C, et al. Eur J Clin Microbiol Infect Dis. 2019;38(6):1105-11.

    • Bezlotoxumab

    • Wilcox MH, et al. N Engl J Med. 2017;376:305-17.
    • Oksi J, et al. Eur J Clin Microbiol Infect Dis. 2019;38(10):1947-52.
    • Hengel RL, et al. Open Forum Infect Dis. 2020;7(4):ofaa097.

      • Bezlotoxumab Cost-effectiveness

      • Salavert M, et al. Adv Ther. 2018;35(11):1920-34.
      • Prabhu VS, et al. Clin Infect Dis. 2018;66(3):355-62.

        • Primary prophylaxis 

        • Pereiras MA, et al. Biol Blood Marrow Transplant. 2017; 23:S395. 
        • Ganetsky A, et al. Clin Infect Dis. 2019;68(12):2003-2009.
        • Mullane KM, et al. Clin Infect Dis. 2019; 68(2):196–203.

          • Secondary prophylaxis  

          • Carignan A, et al. Am J Gastroenterol. 2016;111:1834-1840.
          • Van Hise NW, et al. Clin Infect Dis. 2016;63:651-653.
          • Splinter et al. Ann Pharmacother. 2018;52:113-119.
          • Knight EM, et al. J Pharm Pract. 2019;:897190019825994.
          • Morrisette T, et al. Biol Blood Marrow Transplant. 2019;25(10):2091-2097.
            • ...more
            View all episodesView all episodes
            Download on the App Store
            BreakpointsBy Society of Infectious Diseases Pharmacists
            • 4.9
            • 4.9
            • 4.9
            • 4.9
            • 4.9

            4.9

            159 ratings

            More shows like Breakpoints

            View all
            This Week in Virology by Vincent Racaniello

            This Week in Virology

            2,054 Listeners

            EMCrit FOAM Feed by Scott D. Weingart, MD FCCM

            EMCrit FOAM Feed

            1,869 Listeners

            NEJM This Week by NEJM Group

            NEJM This Week

            316 Listeners

            Let's Talk ID by Infectious Diseases Society of America (IDSA)

            Let's Talk ID

            130 Listeners

            Editors in Conversation by American Society for Microbiology

            Editors in Conversation

            25 Listeners

            The Curbsiders Internal Medicine Podcast by The Curbsiders Internal Medicine Podcast

            The Curbsiders Internal Medicine Podcast

            3,321 Listeners

            Core IM | Internal Medicine Podcast by Core IM Team

            Core IM | Internal Medicine Podcast

            1,101 Listeners

            Run the List by Walker Redd, Emily Gutowski, Navin Kumar, Joyce Zhou, Blake Smith

            Run the List

            251 Listeners

            The Curious Clinicians by The Curious Clinicians

            The Curious Clinicians

            366 Listeners

            Febrile by Sara Dong

            Febrile

            187 Listeners

            ID:IOTS - Infectious Disease Insight Of Two Specialists by Infectious Disease: Insights of Two Specialists

            ID:IOTS - Infectious Disease Insight Of Two Specialists

            25 Listeners

            Infectious Disease Puscast by Vincent Racaniello

            Infectious Disease Puscast

            83 Listeners

            Critical Care Time by Critical Care Time Podcast

            Critical Care Time

            235 Listeners

            Joint Approach by Musculoskeletal Infection Society/European Bone and Joint Infection Society

            Joint Approach

            8 Listeners

            Communicable by CMI Communications

            Communicable

            3 Listeners