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Persevering in a Multidrug-Resistant World: Building a Multiprofessional Alliance to Overcome Gram-negative Resistance

This activity is jointly provided by Center for Independent Healthcare Education and Vemco MedEd.
This activity is supported by an educational grant from Merck & Co., Inc.

Release Date

June 24, 2022

Expiration Date

June 24, 2023

Educational Need

The management of serious Gram-negative bacterial infections, such as nosocomial pneumonia, is complicated by a variety of resistance mechanisms that bypass the effectiveness of antimicrobial therapy. The most concerning Gram-negative bacteria (GNB) include ESBL-producers, carbapenem-resistant bacteria, and AmpC beta-lactamase producers. National and international organizations have identified several pathogens that utilize these resistance mechanisms as significant healthcare threats. Overcoming these mechanisms requires a thorough understanding of the diagnostic techniques needed to identify the resistance phenotype and genotype, as well as selecting an antimicrobial regimen that is tailored for the patient and pathogen.

The most serious outcomes of GNB infections occur in critically ill patients and those with high-risk comorbidities, and the presence of MDR greatly enhances the risk of initial inadequate antimicrobial therapy. Optimizing therapy for MDR GNB infections requires knowledge of how each resistance mechanism can impact antimicrobial therapy, and how to utilize all of the available tools to overcome resistance. The recent expansion of the antimicrobial armamentarium along with rapid molecular diagnostics can allow for antimicrobial “precision medicine” that tailors treatment selection based on the pathogen and resistance phenotype. In addition to selecting an appropriate antimicrobial, advanced practice skills are needed to recognize pharmacokinetic/pharmacodynamic aspects of antimicrobials that can impact treatment success. Efficient utilization of these tools requires coordination and contributions from the various ID team members, particularly the ID physician, clinical pharmacist, and clinical microbiologist.

Target Audience

This activity meets the needs of pharmacists and other healthcare professionals in a variety of practice settings, including large and small healthcare systems, outpatient clinics, managed care organizations, long-term care facilities, and academia who are responsible for caring for patients with serious bacterial infections.

Learning Objectives

After completing this activity, the participant should be better able to:

• Interpret clinical microbiological findings to identify Gram-negative resistance genotypes and phenotypes and understand their impact on medical decisions
• Implement a pathogen-specific approach for multidrug-resistant Gram-negative infections based on patient factors and resistance mechanisms
• Utilize strategies that promote collaboration among team members involved in the management of serious bacterial infections within acute care settings

Educational Program

This activity is based on a CME/CPE satellite symposium presented at the MAD-ID Annual Meeting 2022 on May 19, 2022. The activity is designed to introduce clinicians to the concept map approach to address key unmet needs when managing serious Gram-negative bacterial infections, such as timely diagnosis, appropriate initial treatment selection, and assessing outcomes. Topics to be discussed via a collaborative discussion among the expert panel include:

• Gram-negative resistance mechanisms
• Impact of local epidemiology
• Clinical data of newer antimicrobials for nosocomial pneumonia caused by MDR GNB
• Pharmacokinetics/pharmacodynamics of available antimicrobials
• Patient stratification to guide treatment selection
• Pathogen-specific approaches when managing nosocomial pneumonia
• Incorporating concept maps in clinical practice
• Patient case examples to help demonstrate how to apply the conceptual framework for specific patient scenarios when making clinical decisions

Faculty

George H. Karam, MD, MACP
Paula Garvey Manship Chair of Medicine
Department of Medicine
Louisiana State University School of Medicine in New Orleans
Baton Rouge Branch Campus
Baton Rouge, LA

Jason M. Pogue, PharmD, BCPS, BCIDP
Clinical Professor
Department of Clinical Pharmacy
University of Michigan College of Pharmacy
Ann Arbor, MI

Patricia (Trish) Simner, PhD, D(ABMM)
Associate Professor of Pathology
Johns Hopkins University School of Medicine
Director of the Medical Bacteriology and Infectious Disease Sequencing Laboratories
Johns Hopkins Hospital
Baltimore, MD

Pharmacist Accreditation Statement

Center for Independent Healthcare Education is accredited by the Accreditation Council for Pharmacy Education as a provider for continuing pharmacy education. Center has assigned 1.5 contact hours (0.15 CEUs) of continuing pharmacy education credits for participating in this activity.

ACPE UAN: 0473-9999-22-006-H01-P
Activity type: Application-based

For questions regarding the accreditation of this activity, please contact us at info@jointsponsor.com

Method of Participation and Instruction for Credit

1. Review the entire CPE information including target audience, learning objectives, and disclosures.
2. Review the activity in its entirety.
3. Complete the Online Post Test, Evaluation, and Credit Application form
4. Please note that to receive credit you must achieve a score of at least 80%.
5. The information that you participated will be uploaded to CPE Monitor and you will be able to access your credits from the profile you set up with NABP. For more information, please visit http://www.nabp.net/.

Disclosure of Financial Relationships with Ineligible Companies

Center for Independent Healthcare Education and Vemco MedEd fully comply with the Standards for Integrity and Independence in Accredited Continuing Education in development of CME/CPE activities. We require the full disclosure of financial relationships with ineligible companies from all individuals in a position to influence the content of a certified activity, in any amount occurring within the past 24 months. All relevant financial relationship is identified by the provider and mitigated to prevent inserting commercial bias into content. All identified relevant financial relationships are disclosed to the learners prior to the activity. The faculty is further required to disclose discussion of off-label uses in their presentations.

Disclosures

George Karam, MD has relevant financial relationships with ineligible companies to disclose:

• Advisory Board: Merck & Co., Inc.      
• Consultant: Merck & Co., Inc., Shionogi Inc.

All relevant financial relationships have been mitigated.
Dr. Karam does not discuss off-label uses of any products.

Jason Pogue, PharmD has relevant financial relationships with ineligible companies to disclose:
Consultant: Merck & Co., Inc., Melinta Therapeutics, Shionogi Inc., Qpex
Biopharma, GSK, Entasis, VenatoRx

All relevant financial relationships have been mitigated.
Dr. Pogue does not discuss off-label uses of any products.

Trish Simner, PhD has relevant financial relationships with ineligible companies to disclose:
Research support: BD Diagnostics, OpGen, Inc., Affinity Biosensors, Qiagen, Ares-Genetics, CosmosID, IDbyDNA, Illumina, Shionogi Inc., GeneCapture
Consulting: BD Diagnostics, OpGen Inc., Shionogi Inc., GeneCapture

All relevant financial relationships have been mitigated.
Dr. Simner does not discuss off-label uses of any products.

No (other) speakers, authors, planners or content reviewers have any relevant financial relationships to disclose. Content review confirmed that the content was developed in a fair, balanced manner free from commercial bias. Disclosure of a relationship is not intended to suggest or condone commercial bias in any presentation, but it is made to provide participants with information that might be of potential importance to their evaluation of a presentation.

Fee

There is no fee to participate in this activity.

Copyright Statement

Copyright © 2022 Vemco MedEd. All Rights Reserved. Permission for accreditation use granted to Center for Independent Healthcare Education.