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
Physician CME: 0.75
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.
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.
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.
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.
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
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
Documentation of credit will be mailed within 4 weeks of receipt of the completed
Self-Assessment, Evaluation, and Credit Application form.
- Review the entire CME information including target audience, learning objectives, and disclosures.
- Review this activity in its entirety.
- Complete the Self-Assessment, Evaluation, and Credit Application form.
- 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.
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
Jerome Schentag, PharmD
- Consultant: Roche Laboratories, Bayer Healthcare AG, Advanced Life Sciences, and Boehringer Ingelheim USA Corporation
- Research Support: Bayer Healthcare AG (Principal Investigator)
William Simpson, Jr., MD
- 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
Planning Committee Members
- Speaker’s Bureau: Novartis and Merck
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.
This activity is jointly sponsored by Center for Independent Healthcare Education and Vemco MedEd.
This activity is supported by an educational grant from Schering-Plough Corporation.
There is no fee associated with this activity.
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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
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indications. A qualified healthcare professional should be consulted before using any therapeutic
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