Meeting the Challenges in HABP/VABP

Release Date: Tuesday, November 19, 2019
Expiration Date: Thursday, November 19, 2020

Educational Overview
Hospital-acquired bacterial pneumonia (HABP) and ventilator-associated bacterial pneumonia (VABP) continue to place a substantial clinical and economic burden on healthcare systems despite prevention efforts. VABP is associated with high mortality that can range from 20% to 50%. Though HABP is considered less severe than VABP, serious complications occur in approximately half of these cases. Compounding the challenges of treating HABP/VABP is the prevalence of infections caused by multidrug-resistant (MDR) bacteria, including ESBL-producing and carbapenem-resistant Enterobacteriaceae and MDR P. aeruginosa. As the CDC and WHO have identified these Gram-negative pathogens as serious healthcare threats, Infectious Disease specialists must continue to spread awareness and implement strategies to minimize the burden of these infections that complement antimicrobial stewardship efforts.

Clinicians must be aware of the latest tools that can greatly enhance their ability to effectively identify and manage HABP/VABP caused by MDR Gram-negative pathogens. These tools include rapid diagnostics that can accurately detect resistant pathogens as well as potent antimicrobial agents with novel modes of action that can overcome resistance mechanisms. ID clinicians must have a thorough understanding of the properties of the newer therapeutic options in order to optimally utilize therapeutics in a pathogen-specific manner when confronted with MDR pathogens.

Target Audience
This continuing medical education activity meets the needs of healthcare providers in a variety of practice settings, including large and small health systems, outpatient clinics, managed-care organizations, long-term care facilities, and academia. This activity is especially beneficial for ID physicians and pharmacists who are on the frontline of managing patients with serious bacterial infections.

Learning Objectives
At the conclusion of the educational activity, the learner should be able to:

Discuss current epidemiological trends and resistance mechanisms of multidrug-resistant (MDR) Gram-negative bacteria
Differentiate between hospital-acquired bacterial pneumonia (HABP) and ventilator-associated bacterial pneumonia (VABP) when considering the burden, cause, and management approaches
Identify how to optimally utilize the available tools aimed at improving clinical outcomes of patients with HABP/VABP, including rapid diagnostic techniques and newer antimicrobial agents
Evaluate the benefits in utilizing a pathogen-specific approach when managing patients with HABP/VABP caused by MDR Gram-negative pathogens

Additional Resources
Since the recording of this program, results of the
ASPECT-NP trial were released that compared ceftolozane-tazobactam versus meropenem in the treatment of ventilator-associated pneumonia (VAP) or ventilated hospital-acquired pneumonia (vHAP).

Kollef MH, Novacek M, Kivistek U, et al. Ceftolozane-tazobactam versus meropenem for treatment of nosocomial pneumonia (ASPECT-NP): a randomized, controlled, double-blind, phase 3, non-inferiority trial. Lancet Infect Dis. 2019;pii: S1473-3099(19)30403-7 [Epub ahead of print]. Available at: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(19)30403-7/fulltext

Educational Format

This online presentation builds competence, confidence, and skills in the management of HABP/VABP while increasing the understanding of how to utilize the latest tools as part of antimicrobial stewardship efforts and interprofessional healthcare team. It is divided into 5 episodes.

Episode 1:
Epidemiology and Mechanisms of MDR Gram-Negative Bacterial Infections
Keith Kaye, MD

Episode 2:
Available Tools to Address Challenges of MDR Gram-Negative Infections
George Karam, MD

Episode 3:
Strategies in Managing HABP/VABP: A Review of the Clinical Evidence
Robert Bonomo, MD

Episode 4:
Maximizing Outcomes in the Management of HABP/VABP
James Lewis, PharmD

Episode 5:
Patient Case Presentation
Led by James Lewis, PharmD

Faculty

	Keith S. Kaye MD, MPH Professor of Internal Medicine Director of Research, Division of Infectious Diseases University of Michigan Medical School Ann Arbor, MI
	George H. Karam, MD Paula Garvey Manship Professor of Medicine Department of Medicine Louisiana State University School of Medicine in New Orleans Baton Rouge Branch Campus Baton Rouge, LA
	Robert A. Bonomo, MD, FIDSA Professor of Medicine Case Western Reserve University School of Medicine Chief, Medical Service Louis Stokes Cleveland Department of Veteran Affairs Medical Center Northeast Ohio VA Health Care System Cleveland, OH
	James S. Lewis II, PharmD, FIDSA ID Clinical Pharmacy Coordinator & Adjunct Associate Professor Oregon Health and Science University Departments of Pharmacy & Infectious Diseases Portland, OR

Additional Resources
In November 2019, the Centers for Disease Control and Prevention released its updated report on antibiotic resistance threats in the US, providing valuable information on the prevalence and burden of antibiotic resistance as well as strategies being implemented to combat resistance.

CDC. Antibiotic Resistance Threats in the United States, 2019. Atlanta, GA: U.S. Department of Health and Human Services, CDC; 2019. Available at: https://www.cdc.gov/drugresistance/pdf/threats-report/2019-ar-threats-report-508.pdf

Physicians
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Center for Independent Healthcare Education (Center) and Vemco MedEd. Center is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Center designates this Enduring material for a maximum of 2.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Physician Assistants
AAPA accepts AMA PRA Category 1 Credit™ for the PRA from organizations accredited by ACCME.

Nurse Practitioners
Nurse Practitioners will receive certificate of AMA PRA Category 1 Credit™ as this is an ACCME accredited program and its accreditation is recognized by Nurse Practitioner boards.

Pharmacists
Center for Independent Healthcare Education is accredited by the Accreditation Council for Pharmacy Education as a provider for continuing pharmacy education. Center has assigned 2.0 contact hours (0.2 CEUs) of continuing pharmacy education credits for participating in this activity.
ACPE UAN: 0473-9999-19-006-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

Review the entire CME/CPE information including target audience, learning objectives, and disclosures.
Review the activity in its entirety.
Complete the Online Post Test, Evaluation, and Credit Application form
Please note that to receive credit you must achieve a score of at least 70%.
Pharmacists: The information that you participated will be uploaded to CPEMonitor 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/.
Physicians: Certificate of Credit will be emailed to you within 4 weeks.

Disclosure of Conflicts of Interest

In accordance with policies set forth by the Accreditation Council for Continuing Medical Education (ACCME), Center for Independent Healthcare Education requires all faculty members and spouses/significant others with an opportunity to affect the content of a continuing education activity to disclose any relevant financial relationships during the past 12 months with commercial interests. A commercial interest is any entity producing, marketing, reselling or distributing health care goods or services consumed by or used on patients. Relationships with commercial interests and conflicts of interest resulting from those relationships must be revealed to the audience and resolved prior to the activity.

Relevant relationships include roles such as speaker, author, consultant, independent contractor (including research), employee, investor, advisory committee member, board member, review panelist, and investigator. If a potential speaker or author indicates a possible conflict of interest, the conflict will be resolved by choosing another speaker or author for that topical area, or the slides, handouts, and/or monograph will be reviewed and approved by a qualified commercially-disinterested peer.

Disclosures
Keith S. Kaye, MD has relevant financial relationships with the following commercial interests:
   Advisory Board: Merck & Co., Inc., Melinta Therapeutics, Allergan,
   Nabriva Therapeutics, Shionogi Inc., Xellia Pharmaceuticals
   Research Support: Merck & Co., Inc.

Dr. Kaye does not discuss off-label uses of any products.

George H. Karam, MD has relevant financial relationships with the following commercial interests:
Advisory Board: Merck & Co., Inc., Tetraphase, Shionogi Inc.
Consultant: Merck & Co., Inc., Philips Healthcare, Ilum

Dr. Karam does not discuss off-label uses of any products.

Robert A. Bonomo, MD has relevant financial relationships with the following commercial interests:
Research Support: Wockhardt, Allergan, Allecra Therapeutics, Merck & Co., Inc.,
Shionogi, Achaogen, Roche, VenatoRx, Entasis, Harrington Discovery Institute

Dr. Bonomo does not discuss off-label uses of any products.

James S. Lewis, PharmD has relevant financial relationships with commercial interests:
Advisory Board: Merck & Co., Inc., Tetraphase

Dr. Lewis discusses off-label uses of the following: Non-FDA cleared antibiotics for nosocomial pneumonia/VAP.

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.

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Joint Providership

This activity is jointly provided by Center for Independent Healthcare Education and Vemco MedEd.

Commercial Support
This activity is supported by an educational grant from Merck & Co., Inc.

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