Antibiograms: Back to Basics

RELEASE DATE: 03/23/2011 CREDIT EXPIRATION DATE: 03/23/2013

MODULE OVERVIEW

"Antibiograms: Back to Basics" discusses the prevalence of antimicrobial resistance in the hospital setting and its associated clinical and economic impact. With this as the background, the basics of antibiograms are discussed — their purpose, how to read them, and how to avoid common pitfalls when using them. Understanding these aspects is an important first step when utilizing antibiograms as a routine part of clinical practice to improve patient quality of care.

NAVIGATING THE MODULE

This Module is organized into 3 sections. While you can review these sections based on your preference, we recommend the following order for your review.

Purpose of the Antibiogram

In "Purpose of the Antibiogram", George Zhanel, PharmD, discusses the resistance trends of common nosocomial bacterial pathogens and their clinical and economic consequences. He specifically discusses the ESKAPE pathogens identified by the IDSA as the most problematic bacterial species. You can choose to review all or any of the pathogens of concern in your institution. Against this background, answers to general frequently asked questions about antibiograms are presented.

George G. Zhanel, PharmD, PhD
Professor, Department of Medical Microbiology and Infectious Diseases
Faculty of Medicine
University of Manitoba, Winnipeg, Canada

Reading the Antibiogram

After reviewing the basics about antimicrobial resistance and the purpose of antibiograms, you can proceed to "Reading the Antibiogram". Robert Rapp, PharmD, presents a simple antibiogram and explains through a step-by-step process how to read the data presented and how to interpret it when choosing appropriate initial empiric therapy for a patient. You can select any part of the sample antibiogram presented to understand the data presented and its clinical implications.

Robert P. Rapp, PharmD, FCCP
Professor of Pharmacy Emeritus,
College of Pharmacy
Professor of Surgery Emeritus,
College of Medicine
University of Kentucky Medical Center
Lexington, Kentucky

Avoiding Common Pitfalls

After you learn the basics about reading the antibiogram, you can review "Avoiding Common Pitfalls". In this section, Janet Hindler, MCLS, discusses some of the limitations of antibiogram reports and how you can use these reports effectively and accurately. Through examples of studies and guideline recommendations, she talks about minimum number of isolates, multi-institutional antibiograms, frequency of antibiograms, key limitations, data stratification and limitations in guiding combination therapy.

Janet F. Hindler, MCLS, MT (ASCP)
Senior Specialist, Clinical Microbiology
UCLA Medical Center
Los Angeles, California

Target Audience

This educational activity is designed for hospital healthcare professionals, including hospital pharmacists, physicians, microbiologists, infection control personnel, who would benefit from a better understanding of antibiograms to guide clinical decision-making and empiric therapy.

Learning Objectives

After participating in this educational activity, learners should be better able to:

Describe antimicrobial resistance trends of nosocomial bacterial pathogens and their consequences
State the purpose of an antibiogram
Interpret an antibiogram to guide empiric antimicrobial selection
Identify potential weaknesses and limitations of an antibiogram

Accreditation

Physicians

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the University of Kentucky College of Medicine and Vemco MedEd. The University of Kentucky College of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

The University of Kentucky College of Medicine designates this Internet Enduring Activity for a maximum of 1 AMA PRA Category 1 Credits^TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The University of Kentucky College of Medicine presents this activity for educational purposes only. Participants are expected to utilize their own expertise and judgment while engaged in the practice of medicine. The content of the presentations is provided solely by presenters who have been selected for presentations because of recognized expertise in their field.

Pharmacists

Center for Independent Healthcare Education (Center) is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. Center has assigned 1.0 contact hours (0.1 CEUs) for this activity.

ACPE Universal Activity Number: 0473-9999-11-002-H01-P

Type of Activity: Knowledge-based

Instructions for Obtaining Credit: Physicians

Attend activity in its entirety.
Post activity, go to www.CECentral.com/getcredit.
Enter activity code XEN11057.
Login or register for a free account.
Complete evaluation.
Get credit. A printable certificate will be issued.

Instructions for Obtaining Credit: Pharmacists

Review the entire CME/CPE information including target audience, learning objectives, and disclosures.
Review the complete activity.
Complete the online Post Test, Evaluation, and Credit Application form. Please note that:
you have to sign in to access the form.
a score of at least 80% on the Post Test is necessary to receive credit.
Upon successful completion, a certificate will be available to print.

Disclosure of Conflicts of Interest

University of Kentucky and Center for Independent Healthcare Education require 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 and resolved 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.

Disclosure: Planning Committee Members

Employees of University of Kentucky, Center for Independent Healthcare Education, and Vemco MedEd have no relevant financial relationships to disclose.

Disclosure: Contributing Editors

In accordance with policies set forth by the Accreditation Council for Continuing Medical Education (ACCME) and the Accreditation Council for Pharmacy Education (ACPE), University of Kentucky UK HealthCare CECentral (UKHCCEC) and Center for Independent Healthcare Education require 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, re-selling 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.

Disclosure of a relationship is not intended to suggest or condone any bias in any presentation, but is made to provide participants with information that might be of potential importance to their evaluation of a presentation.

Faculty/Spouse/ Significant Other	Intend to discuss off-label use of a product	Commercial Interest	Role	Received	Conflict(s) resolved
Janet Hindler	No	BD Diagnostics, bioMerieux, Forest Laboratories, and Siemens Healthcare Diagnostics	Speakers bureau/ advisory board	Yes	Yes
Robert P. Rapp	No	Astellas, Ortho-McNeil, and Pfizer	Speaker/consultant	Yes	Yes
George G. Zhanel	No	Astellas, Cubist, and Ortho-McNeil	Research funding	Yes	Yes

Joint Sponsorship

This activity is jointly sponsored by University of Kentucky College of Medicine, Center for Independent Healthcare Education, and Vemco MedEd.

Commercial Support

This activity is supported by educational grants from Janssen Pharmaceuticals, Inc., administered by Janssen Scientific Affairs, LLC; Astellas Pharma Global Development, Inc.; and Cubist Pharmaceuticals.

Fee

There is no fee to participate in this activity.

Copyright Statement

Contact Information

For questions regarding the accreditation of this activity,

Physicians: please contact University of Kentucky Healthcare CE Central: Christopher Dennison at Crdenn2@email.uky.edu; Phone: (859) 218 0329.
Pharmacists: please contact Center for Independent Healthcare Education at info@jointsponsor.com.

Hardware/Software Requirements

Web Browser

Microsoft Internet Explorer, Mozilla Firefox, Apple Safari or Google Chrome with the QuickTime Plug-in
Note: Please disable any "pop-up blocker" features.

Software/Hardware

Adobe Reader version 7 or above to view PDF files (If you do not have Adobe Reader, you can download it for free from Adobe.com)
Adobe Flash Player version 10 or above to view multimedia content (If you do not have Adobe Flash Player, you can download it for free from Adobe.com)

Connection Speed

Cable, DSL, or better of at least 300 Kbps

System Check

Please e-mail any questions or concerns to info@bugsvsdrugs.com.

Review Activity

By clicking on the icon below, I acknowledge that I have read the entire CME/CE information.