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CME: Taking cover(age): optimizing antimicrobial therapy in the treatment of hospital- and ventilator-acquired bacterial pneumonia

Activity Description / Statement of Need:

In this online, self-learning activity:

Hospital-acquired pneumonia (HAP) occurs at an estimated rate of five to ten per 1,000 hospital admissions and is the most common cause of hospital-acquired infection in the United States. It is defined as pneumonia that develops at least 48 hours after hospital admission and did not appear to be incubating at the time of admission. A significant subset of HAP that occurs most frequently in intensive care units (ICUs) is ventilator-associated pneumonia (VAP), which is defined as pneumonia that occurs more than 48 to 72 hours after tracheal intubation and is thought to affect approximately 10 to 20% of patients who receive mechanical ventilation for more than 48 hours. Altered mechanical defenses, such as impaired ciliary motion and mucus secretion, increase the susceptibility for acquiring pneumonia in intubated patients, with over 90% of pneumonia episodes that develop in ICUs occurring in patients who are intubated or mechanically ventilated.

Target Audience:

HCPs including: pulmonologists, infectious disease specialists, and intensivists; physician assistants, nurse practitioners, and pharmacists specializing in infectious disease or critical care; and any other healthcare professionals with an interest in or clinically encounter patients with HAP or VAP.


Commercial Support Disclosure: This program is supported by an educational grant from Shionogi Inc.

This activity is free of charge.


Release Date: August 01, 2023 -- Expiration Date: August 01, 2025

Faculty: Kusha Davar, MD, MBA, MS

Agenda

Faculty introduction and disclosures

HAP/VAP refresher and primer

● Definitions

● Clinical presentation and diagnostic evaluation

● Epidemiology, pathogenesis, and microbiology [Learning Objective #1]

● Challenges surrounding antimicrobial resistance and understanding local resistance patterns

Treatment of HAP and VAP

● Duration of antibiotic therapy

● Optimizing initial empiric antibiotic therapy selection based on guideline recommendations, application of institutional antibiograms, and evaluation of risk factors for multidrug resistance

● Differences in coverage of antibiotic regimens and considerations related to specific agents

○ Anti-pseudomonal monotherapy vs. combination therapy

○ Novel antibiotics with broad gram-negative MDR coverage

○ Anti-MRSA agents

● Antimicrobial stewardship 

○ De-escalating antibiotics based on susceptibilities

● Monitoring for clinical improvement, potential toxicities associated with certain antibiotics, and/or drug allergies

● Putting it all together: patient case(s)

Summary, conclusions, and best practice recap

Learning Objectives

By the end of the session the participant will be able to:

  • Recall the most common causative pathogens in HAP and VAP.
  • Describe the key differences between antimicrobial therapies, including recently approved antibiotics targeting gram-negative pathogens.
  • Summarize strategies to optimize antimicrobial therapy in HAP or VAP to ensure appropriate pathogen coverage and minimize antibiotic resistance.
  • Formulate a treatment plan for a patient with HAP or VAP.

Accreditation

ACCME Activity #202525264

ScientiaCME is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.

CME-MOC_badge

ABIM MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

ABIM MOC Credit Type: Medical Knowledge

Physicians: For maintenance of certification (MOC) points, you must enter your board certification ID # and birth date correctly.  It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC points for this activity. By providing this data, you acknowledge that it will be shared with ACCME and the applicable certifying board. Please note: Not all activities on this site provide MOC points. If this activity does not specify that it provides MOC points in this section, then it does NOT provide MOC points. This activity provides MOC points only for ABIM.

Pharmacists

ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 1.0 contact hours (0.1 CEUs) of continuing pharmacy education credit. Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test. Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit. ACPE #0574-0000-23-022-H01-P. This is an Application (A)-type activity. 

PharmacistsYou must enter your NABP # and birth date correctly so that proof of participation can be posted to your NABP CPE profile. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive CPE credit for this activity.

Nurse Practitioners (NPs): The American Academy of Nurse Practitioners accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME. ScientiaCME will provide NPs who successfully complete each activity with a certificate of participation indicating that the activity was designated for AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.


Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review by ScientiaCME.

Disclosures of Faculty: Kusha Davar, MD, MBA, MS, Assistant Program Director, Division of Infectious Diseases, Keck School of Medicine, LAC+USC Medical Center, has no relevant financial disclosures.

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant financial disclosures.

Faculty will NOT discuss off-label uses of a commercial product.

All relevant financial relationships have been mitigated.

ScientiaCME adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CE activity, including faculty, planners, reviewers or others are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.

Instructions

  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural/Linguistic Competence & Health Disparities

System Requirements

PC
Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
MAC
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version


Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.


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