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Appropriate Antibiotic Selection in Multidrug-Resistant Pneumonia with Gram-Negative Bacteria: Identifying Pathogens and Related Antimicrobial Stewardship

Appropriate Antibiotic Selection in Multidrug-Resistant Pneumonia with Gram-Negative Bacteria: Identifying Pathogens and Related Antimicrobial Stewardship

Format

Patient Case Study

Time to Complete

30 minutes

Released

November 30, 2018

Expires

November 30, 2019
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Maximum Credits

0.50 / AMA PRA Category 1 CreditsTM
0.50 / CE for Pharmacists (0.05 CEUs)

Accredited Provider



Provided by the Academy for Continued Healthcare Learning (ACHL).

Commercial Supporter

Supported by an educational grant from Merck & Company.

Program Description

Filmed at a prominent infectious disease meeting in October 2018, experts James Lewis, PharmD and James McKinnell, MD offer a lively discussion and clinical analysis of current optimal management of multidrug-resistant Gram-negative pseudomonas-based pneumonia infections in the context of a complex patient case. The purpose of this activity is to update physicians and pharmacists that may come in clinical contact with serious, treatment-refractory bacterial infections such as Gram-negative infections with the latest clinical evidence, practice guidelines, and antimicrobial stewardship protocols for providing optimal treatment.

Agenda

  • 1. Patient Case: Multidrug-resistant pneumonia in a 65-yo female transferred from an outside hospital to UCLA Medical Center: Decision points, lab isolates, and local susceptibilities.
  • 2. Therapeutic selection according to combination local antibiograms/susceptibilities.
  • 3. Evaluation of currently available agents and pipeline agents for Gram-negative infections.

Intended Audience

This activity is intended for ID specialists, hospitalists, pulmonologists, critical care specialists, internists, and other physicians, pharmacists, nurse practitioners, and physician assistants who care for patients at risk of serious infection.

Educational Objectives

Upon completion of this activity, participants will be able to:

  • Demonstrate an understanding of the molecular epidemiology of antibiotic resistance in bacterial pathogens.
  • Summarize the salient features and critical differences between novel antibiotics for use against Gram-negative pathogens.
  • Describe clinical strategies to optimize antimicrobial therapy to ensure effectiveness of antibiotics and reduce resistance.

Pharmacy Educational Objectives
Upon completion of this activity, participants will be able to:

  • Demonstrate an understanding of appropriate antimicrobial stewardship in the context of increased resistance in high-risk bacterial pathogens.
  • Summarize the pharmacokinetics and spectrums of activity of novel antibiotics for use against Gram-negative pathogens versus established therapies.
  • Describe clinical strategies to implement current pharmacy best practices to ensure effectiveness of antibiotics and reduce resistance in Gram-negative pathogens.

Conflict Of Interest Disclosure Policy

The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in a CME activity disclose all affiliations or other financial relationships (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. All conflicts of interest have been resolved prior to this CME activity.

Faculty

James Lewis, II, PharmD, FIDSA
Infectious Disease Clinical Pharmacy Supervisor
Co-Director of Antibiotic Stewardship
Department of Pharmacy
Oregon Health & Science University
Portland, Oregon

Dr. Lewis, II discloses the following:
Consultant: Accelerate Diagnostics, Achaogen, Merck, Tetraphase Pharmaceuticals, and The Medicines Company

James McKinnell, MD
Assistant Professor of Medicine
David Geffen School of Medicine
University of California, Los Angeles
Infectious Disease Clinical Outcome Research Unit
Los Angeles Biomedical Research Institute at Harbor-UCLA
Torrance, California

Dr. McKinnell discloses the following:
Consultant: Achaogen, Allergan, Accelerate, Melinta/Menarini, and Thermo Fisher Scientific
Speakers Bureau: Allergan

Accredited Provider Disclosures

ACHL staff members and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

Credit

0.50

Type

AMA PRA Category 1 Credit(s)TM

Accreditation Statement

The Academy for Continued Healthcare Learning is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement

The Academy for Continued Healthcare Learning designates this enduring material for a maximum of 0.50 AMA PRA Category 1 CreditsTM .  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Credit

0.50

Type

CE for Pharmacists

Accreditation Statement

The Academy for Continued Healthcare Learning is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Designation Statement

This activity has been approved for 0.50 contact hours (0.05 CEUs).
ACPE Universal Activity Number: 0396-0000-18-069-H01-P
Activity Type: Knowledge

Disclosure of Unlabeled Use

This CME/CPE activity might describe the off-label, investigational, or experimental use of medications that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers’ prescribing information for these products. ACHL requires the speaker to disclose that a product is not labeled for the use under discussion.

Discussion of Off-Label, Investigational, or Experimental Drug/Device Use: Antibiotics currently FDA approved for the treatment of only certain types of Gram-negative infections, eg, complex UTIs, rather than ventilator-associated pneumonias (VAPS) and/or hospital-acquired pneumonias (HAPs).

Disclaimer

The content for this activity was developed independently of the commercial supporter. All materials are included with permission. The opinions expressed are those of the faculty and are not to be construed as those of the publisher or grantor.

This educational activity was planned and produced in accordance with the ACCME Accreditation Criteria, Policies, and Standards for Commercial Support, as well as the ACPE Accreditation Standards for Continuing Pharmacy Education. Recommendations involving clinical medicine in a continuing medical education (CME/CPE) activity must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported, or used in CME/CE in support or justification of a patient care recommendation must conform to the generally accepted standards of experimental design, data collection, and analysis.

Instructions

This activity will take approximately 30 minutes to complete. To receive credit, participants are required to view the online activity and complete the posttest and evaluation. To receive credit, 66% must be achieved on the posttest. A certificate will be immediately available. There is no fee to participate in the activity or for the generation of the certificate. CPE credit will be submitted to CPE Monitor® on the first day of each month.

If you have any questions relating to the accreditation of this activity, please contact:
Katlyn Cooper
kcooper@achlcme.org

SYSTEM REQUIREMENTS

Hardware and Software Requirements
  • A computer with an internet connection
  • Internet Browser: Internet Explorer 7.x or higher, Firefox 4.x or higher, Safari 2.x or higher, or any other W3C standards compliant browser
  • Additional Software: Adobe Flash Player and/or an HTML 5 capable browser maybe required for video or audio playback. PowerPoint or Adobe Acrobat Reader may occasionally be required
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