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RTI Resistance On the Frontline of Care: PCPs Fight Back!
E-Bulletin 1: To Prescribe or Not: Differentiating the Need for Antimicrobials in RTIs

Release Date: September 9, 2009
Credit Expiration Date: September 9, 2010

Credit Hours
Physician CME: 0.75

Activity Overview
This E-Bulletin is part of the RTI Resistance On the Frontline of Care: PCPs Fight Back! Initiative.

  • The first part of this Initiative consisted of a live symposium with simulcast, now available as On-demand Webinar. In the webinar, infectious diseases experts discuss scientific evidence pertaining to antimicrobial resistance and therapy in outpatient setting. (On-demand webinar available at Vemco MedEd website/CME Portal)
  • Three E-Bulletins represent the second part of this Initiative. Scientific evidence presented during the live meeting is reinforced and placed in clinical context.
  • This first Bulletin, To Prescribe or Not: Differentiating the Need for Antimicrobials in RTIs, focuses on two important practice topics:
    • When an antimicrobial is appropriate for patients who present with an RTI
    • How to select the appropriate agent when a bacterial infection is suspected.

Educational Overview
The difficulty in the outpatient management of RTIs has grown in recent years with increasing rates of antimicrobial resistance in the community, particularly by Streptococcus pneumoniae. Part of this growing resistance trend is attributed to the overuse of antimicrobial agents, especially for viral infections. Appropriate management of RTI patients will require the primary care physician to first differentiate viral and bacterial infections followed by the judicious and appropriate use of antimicrobial agents.

The appropriate management of RTIs in the primary care setting can be challenging given the time-consuming process of an accurate diagnosis. In the absence of culture results, physicians must rely on patient history and signs and symptoms to better determine when an antimicrobial is required. Patient risk factors for a resistant infection must also be considered prior to antimicrobial selection.

Through this educational initiative, physicians will learn how to more accurately assess RTI patients for the presence of a bacterial versus viral infection and recognize when an antimicrobial is necessary. Current resistance trends by RTI pathogens will be discussed to increase awareness of the prevalence of resistance in the community. Finally, physicians will learn how to appropriately select antimicrobial agents to minimize resistance development and improve clinical outcomes in the timeliest manner.

Target Audience
This educational initiative has been designed to meet the needs of physicians and other healthcare professionals involved in the diagnosis, management, and treatment of outpatients with RTIs.

Purpose Statement
The purpose of this initiative is to educate primary care physicians and other healthcare professionals on when an antimicrobial agent is needed to treat an RTI, identifying the risk factors for a resistant RTI, and optimizing antimicrobial therapy. With this knowledge, healthcare professionals involved in the diagnosis, management and treatment of outpatients with RTIs will be able to tailor therapy to achieve successful outcomes.

Learning Objectives
At the conclusion of this activity, learners should be able to

  • Determine when an antimicrobial agent is needed to treat a respiratory tract infection

Donald E. Low, MD, FRCPC
Microbiologist-in-Chief, University Health Network/Mount Sinai Hospital
Medical Director, Public Health Laboratories
Ontario Agency for Health Protection and Promotion
Toronto, Ontario

Jerome J. Schentag, PharmD
Professor of Pharmaceutical Sciences and Pharmacy
University at Buffalo School of Pharmacy and Pharmaceutical Sciences
Buffalo, New York

William M. Simpson, Jr., MD
Professor of Family Medicine
Medical University of South Carolina
Charleston, South Carolina

Accreditation Statement: This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through joint sponsorship of Center for Independent Healthcare Education (Center) and Vemco MedEd.

Center is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: Center designates for this activity maximum of 0.75 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Method of Participation and Instruction for Credit

  1. Review the entire CME information including target audience, learning objectives, and disclosures.
  2. Review this activity in its entirety.
  3. Complete the Self-Assessment, Evaluation, and Credit Application form.
  4. Mail the completed Self-Assessment, Evaluation, and Credit Application form to Vemco MedEd, 245 US Highway 22, Suite 304, Bridgewater, NJ 08807 Or Fax to (908) 450-3300.
Documentation of credit will be mailed within 4 weeks of receipt of the completed Self-Assessment, Evaluation, and Credit Application form.

Disclosure of Conflicts of Interest
Center for Independent Healthcare Education requires faculty, planners, and others who are in a position to control the content of continuing education activities to disclose to the audience any real or apparent conflict of interest related to the activity. All identified conflicts of interest are reviewed to ensure balance, objectivity, and scientific rigor in all activities. The faculty is further required to disclose discussion of off-label uses in their presentations.

Donald Low, MD

  • Consultant: Roche Laboratories, Bayer Healthcare AG, Advanced Life Sciences, and Boehringer Ingelheim USA Corporation
  • Research Support: Bayer Healthcare AG (Principal Investigator)
Jerome Schentag, PharmD
  • Advisory Boards: Optimer, Targanta, Astellas, and Novartis
  • Consultant: Daiichi-Sankyo, Eisai, and Premier Healthcare
  • Grant/Research Support: Wyeth, Astellas, and Daiichi-Sankyo
  • Board Member/Shareholder: TheraSyn and CPL Associates
  • Patent Holder: University of Buffalo and TheraSyn
William Simpson, Jr., MD
  • Speaker’s Bureau: Novartis and Merck
Planning Committee Members
Employees of Center for Independent Healthcare Education and Vemco MedEd have no relevant financial relationships to disclose.

Off-label Disclosure Statement
The off-label use of any antimicrobial agent is not discussed during this activity.

Joint Sponsorship
This activity is jointly sponsored by Center for Independent Healthcare Education and Vemco MedEd.

Commercial Support
This activity is supported by an educational grant from Schering-Plough Corporation.

There is no fee associated with this activity.

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Internet Explorer or Mozilla
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Adobe Acrobat Reader version 4 or above to view PDF files (If you do not have Acrobat Reader, you can download it for free from http://get.adobe.com/reader)

Connection Speed
Cable, DSL, or better of at least 300 kbps

PC or Apple

System Check
Please e-mail any questions or concerns to info@vemcomeded.com.

Copyright Statement
Copyright © 2009 Vemco MedEd, LLC. All Rights Reserved. Permission for accreditation use granted to Center for Independent Healthcare Education.

The opinions expressed in this educational activity are those of the faculty and do not reflect the views of Center for Independent Healthcare Education (Center) and Vemco MedEd. This educational activity may discuss off-label and/or investigational uses and dosages for therapeutic products/procedures that have not been approved by the United States Food and Drug Administration (FDA). Center and Vemco MedEd do not recommend the use of any product/procedure outside of the labeled indications. A qualified healthcare professional should be consulted before using any therapeutic product/procedure discussed. Clinicians should verify all information and data before treating patients or employing any therapies described in this continuing education activity. Please refer to the prescribing information for each product/procedure for approved indication, contraindications, and warnings.

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Contact Information
For questions regarding the accreditation of this activity, please contact Center for Independent Healthcare Education at info@jointsponsor.com

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