Hot Topic: Translating the Updated IDSA C. difficile Infection Guidelines to Clinical Practice

Activity Post Test and Evaluation Form

Post Test

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Question Title

* 1. All of the following are key factors in the pathophysiology of C. difficile infection except:

Antimicrobial exposure

Dysbiosis

Augmented host immune response

Colonization by pathogenic C. difficile

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* 2. Risk factors for CDI recurrence include all of the following except:

Older age

Recent hospitalization

History of recurrent CDI episode

Termination of gastric acid suppression

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* 3. Clinical trials demonstrate that, compared to vancomycin, the use of fidaxomicin in the treatment of CDI resulted in significantly:

Higher overall clinical cure rates

Higher clinical cure rates for moderate-to-severe CDI only

Lower clinical cure rates in patients with mild infection

Lower rates of recurrent infection

Question Title

* 4. For a patient with multiple recurrent episodes of CDI, the IDSA/SHEA guidelines recommend any of the following treatments except:

Vancomycin plus metronidazole

Vancomycin with rifaximin chaser

Fidaxomicin

Fecal microbiota transplantation

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* 5. Bezlotoxumab is a monoclonal antibody that targets which of the following C. difficile toxins?

Toxin A

Toxin B

Both Toxin A and B

Binary toxin

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* 6. A 64-year-old woman was hospitalized for community-acquired pneumonia and developed an initial episode of C. difficile infection. She was successfully treated with a 10-day course of vancomycin 125 mg given 4 times daily. She returns to the hospital 3 weeks after discharge after experiencing severe abdominal pain and 8 episodes of diarrhea in the past 24 hours. Laboratory testing supports a CDI diagnosis. According to the latest IDSA/SHEA guidelines, appropriate treatment can include any of the following except:

Vancomycin 125 mg four times daily

Prolonged tapered vancomycin regimen

Pulsed vancomycin regimen

Standard dose fidaxomicin