Activity Overview
This online activity is based on the continuing education symposium held on June 27, 2009 in Tempe, Arizona and its simulcast.

This educational activity consists of 4 learning modules— 3 Scientific Evidence Presentations with ViewPoints and a Multi-Disciplinary Panel Discussion with Clinical Pearls for the Management of Respiratory Tract Infections (RTIs).

• Dr. Simpson addresses the need for accurate diagnosis of viral versus bacterial infections. This is followed by a panel viewpoint discussion: Site of Care.
• Dr. Low presents scientific evidence on continuous emergence of antimicrobial resistance threat. This is followed by a panel viewpoint discussion: To culture or not?
• Dr. Schentag discusses optimizing antimicrobial therapy to achieve successful patient outcomes. This is followed by a panel viewpoint discussion: Dead bugs don't mutate.
• Panel discussion with Clinical Pearls for Management of RTIs emphasizes 3 aspects critical in reducing RTI resistance
• Knowing when to prescribe an antimicrobial
• Recognizing the threat for a resistant infection
• Selecting the optimal agent

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 activity, 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 activity 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 educational activity, learners should be able to:

• Determine when an antimicrobial agent is needed to treat a respiratory tract infection (RTI)
• Identify the risk factors for a resistant RTI
• Optimize antimicrobial therapy to achieve successful outcomes

Faculty
Donald E. Low, MD (Moderator)
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
Physicians
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 a maximum of 1.75 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Physician Assistants
American Academy of Physician Assistants accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credits™ from organizations accredited by ACCME. Physician assistants may receive a maximum of 1.75 hours of Category I credit for completing this activity.
For questions regarding the accreditation of this activity, please contact Center at info@jointsponsor.com

Method of Participation and Instruction for Credit
Review the entire CME information including target audience, learning objectives, and disclosures.

1. Review the four learning modules in their entirety.
2. Print and complete the Self-Assessment, Evaluation, and Credit Application form.
3. 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 fair balance, objectivity, and scientific rigor in all activities. The faculty is further required to disclose discussion of off-label uses in their presentations.

Disclosures
Faculty
Donald Low, MD serves as a consultant for Roche Laboratories, Bayer Healthcare AG, Advanced Life Sciences, Boehringer Ingelheim USA Corporation. He has received research support from Bayer Healthcare AG (Principal Investigator).

Jerome Schentag, PharmD serves on the advisory boards for Optimer, Targanta, Astellas, and Novartis. He is a consultant for Daiichi-Sankyo, Eisai, and Premier Healthcare. He has received grant/research support from Wyeth, Astellas, and Daiichi-Sankyo. He is a board member and shareholder for TheraSyn and CPL Associates, and a patent holder for University of Buffalo and TheraSyn.

William Simpson, Jr., MD serves on the promotional Speaker’s Bureau for Novartis and Merck.

Planning Committee Members
Employees of Center for Independent Healthcare Education and Vemco MedEd have no relevant financial relationships to disclose.

Disclosure of Off-label Use
During this activity, off-label or investigational uses of commercial products will not be discussed

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.

Fee
There is no fee associated with this activity.

Hardware/Software Requirements
Software
Microsoft Internet Explorer or Mozilla Firefox
Note: Please disable any “pop-up blocker” features.

Adobe® Flash® Player to view the presentations (If you do not have Adobe® Flash® Player, you can download it for free from get.adobe.com/flashplayer)
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 get.adobe.com/reader)

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

Hardware
PC or Macintosh to view the presentations
Audio Speakers

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.

Disclaimer
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