PO Box 1488
Warrenville, IL 60555
Phone: 331.248.7888
Email: sidp@affinity-strategies.com
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.
Kevin Garey PharmD, MS, FIDSA, FASHP
Dr. Kevin Garey is a professor at the University of Houston College of Pharmacy and Chair of the Department of Pharmacy Practice and Translational Research. He is an Adjunct Professor at the University of Texas School of Public Health and a Clinical Specialist and Researcher at Baylor St. Luke’s Medical Center, Houston, Texas. Dr. Garey’s research interests are centered on clinical and translational research in healthcare associated infections including healthcare-related infections, candidemia, and Clostridium difficile infection.
Kelly Reveles PharmD, PhD, BCPS, BCIDP
Dr. Kelly Reveles is an Associate Professor with the Pharmacotherapy Division, College of Pharmacy, The University of Texas at Austin and an Adjoint Associate Professor with the Pharmacotherapy Education and Research Center, School of Medicine, The University of Texas Health Science Center at San Antonio. Her research interests include Clostridium difficile infection, microbiome science, translational science, comparative-effectiveness research, patient-centered outcomes research, and pharmacoepidemiology
Mandelin Cooper PharmD, BCPS, BCIDP
Dr. Mandelin Cooper is the director of clinical pharmacy for HCA healthcare. She has a background in infectious diseases and is the pharmacist lead for stewardship for the healthcare system. Her expertise is in systems, processes, and practical antimicrobial stewardship.
