Use It, Lose It, or Something in Between? Expert Perspectives on the Utility of Antibiotic Susceptibility Testing in Cystic Fibrosis Treatment Planning
E-publication E-publication

Use It, Lose It, or Something in Between? Expert Perspectives on the Utility of Antibiotic Susceptibility Testing in Cystic Fibrosis Treatment Planning


Released:
5/1/2015
Expires:
4/30/2016

Maximum Credits:

0.75

E-publication E-publication
Released:
5/1/2015

Expires:
4/30/2016

Maximum Credits:
0.75
E-publication E-publication

Released:
5/1/2015
Expires:
4/30/2016


Maximum Credits:
0.75


Overview: In February 2015, Med-IQ convened a meeting of four expert faculty to weigh the benefits and limitations of antibiotic susceptibility testing to guide treatment decisions for pulmonary exacerbations in cystic fibrosis (CF). This online publication incorporates audio clips of key points from their discussion to enhance available clinical evidence and provide consensus-based guidance to physicians who regularly face the challenge of selecting intravenous antibiotics for their patients with CF.

CME Information:

Faculty
Patrick A. Flume, MD
Professor of Medicine and Pediatrics
Powers-Huggins Endowed Chair for Cystic Fibrosis
Medical University of South Carolina
Charleston, SC

Donald R. (Dutch) VanDevanter, PhD
Adjunct Associate Professor of Pediatrics
Case Western Reserve University School of Medicine
Cleveland, OH

Valerie J. Waters, MD, MSc
Associate Professor, Department of Paediatrics
University of Toronto
Toronto, ON

Natalie E. West, MD, MHS
Assistant Professor of Medicine
Assistant Director, Fellowship Training Program
Division of Pulmonary and Critical Care Medicine
Johns Hopkins University
Baltimore, MD

Activity Planners
Allison Gardner, PhD
Vice President, Educational Strategy and Content
Med-IQ
Baltimore, MD

Laura Espinoza
Associate Managing Editor
Med-IQ
Baltimore, MD

Amy Sison
Director of Continuing Medical Education
Med-IQ
Baltimore, MD

Writer
Lori K. Pender, PharmD, MPH, ELS
Seattle, WA

Learning Objectives
Upon completion, participants should be able to:

  • Describe mechanisms by which bacteria associated with acute exacerbations of CF lung disease evade IV antibiotic treatment
  • Incorporate clinical evidence regarding the benefits and limitations of antibiotic susceptibility testing when selecting IV antibiotic therapy for pulmonary exacerbations in CF

Target Audience
This activity is intended for pulmonologists who treat patients with cystic fibrosis.

Statement of Need
Pulmonary exacerbations in cystic fibrosis (CF), driven largely by bacterial colonization of the airway, present a substantial clinical challenge for physicians who treat this patient population. Initial treatment involves empiric intravenous antibiotic therapy. However, the benefit of adjusting this regimen based on the results of in vitro susceptibility testing conducted on cultures obtained from sputum samples—performed for the majority of other bacterial infections managed in the hospital setting—is limited in this context. Clinical evidence has repeatedly demonstrated that in vitro drug sensitivity does not reliably predict in vivo activity in the CF lung, and regimens chosen based on in vitro features do not influence clinical outcomes. However, many pulmonologists continue to tailor therapy based on arbitrary susceptibility breakpoints. Although the best treatment approach for each clinical scenario is guided more by art and experience rather than hard science, pulmonologists need clarification on the benefits and limitations of susceptibility testing in this setting, as well as the factors that should be considered when selecting therapy to limit both short- and long-term detrimental effects of acute exacerbations on outcomes for their patients with CF.

Accreditation/Designation Statements
Med-IQ is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Med-IQ designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurse practitioners, physician assistants, and other healthcare professionals who successfully complete the activity will receive a Statement of Participation indicating the maximum credits available.

Medium/Method of Participation
This CME activity consists of a 0.75-credit online publication. To receive credit, read the introductory CME material, read the publication, and complete the post-survey, evaluation, attestation, and post-test, answering at least 70% of the post-test questions correctly.

Original Release Date:  May 1, 2015
Expiration Date:  April 30, 2016
Estimated Time to Complete This Activity:  45 minutes

Disclosure Policy
Med-IQ requires any person in a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines “relevant financial relationships” as those in any amount occurring within the past 12 months, including those of a spouse/life partner, that could create a conflict of interest (COI). Individuals who refuse to disclose will not be permitted to contribute to this CME activity in any way. Med-IQ has policies in place that will identify and resolve COIs prior to this educational activity. Med-IQ also requires faculty to disclose discussions of investigational products or unlabeled/unapproved uses of drugs or devices regulated by the US Food and Drug Administration.

Disclosure Statement
The content of this activity has been peer reviewed and has been approved for compliance. The faculty and contributors have indicated the following financial relationships, which have been resolved through an established COI resolution process, and have stated that these reported relationships will not have any impact on their ability to give an unbiased presentation.

Patrick A. Flume, MD
Consulting fees/advisory boards: Enanta Pharmaceuticals, Inc, Gilead Sciences, Inc., Insmed Incorporated, Novartis Pharmaceuticals Corporation, Pharmaxis Ltd., Savara Inc., Vertex Pharmaceuticals Incorporated
Fees received for promotional/non-CME activities: Genentech
Contracted research: Bayer HealthCare Pharmaceuticals, Gilead Sciences, Inc., Hill-Rom Holdings, Inc., Insmed Incorporated, KaloBios, Nivalis Therapeutics, Inc., Novartis Pharmaceuticals Corporation, Pharmaxis Ltd., Savara Inc., Vertex Pharmaceuticals Incorporated

Donald R. (Dutch) VanDevanter, PhD
Consulting fees/advisory boards: Aradigm Corporation, Baxter, Cystic Fibrosis Foundation, CURx Pharmaceuticals, Inc., Forest Laboratories, Inc., Genentech, Gilead Sciences, Inc., GlycoMimetics, Inc., ICON plc, MedImmune, Savara Inc., Vertex Pharmaceuticals Incorporated

Valerie J. Waters MD, MSc, has indicated no real or apparent conflicts.

Natalie E. West, MD, MHS, has indicated no real or apparent conflicts.

The writer, activity planners, and peer reviewers have no financial relationships to disclose.

Statement of Evidence-Based Content
Educational activities that assist physicians in carrying out their professional responsibilities more effectively and efficiently are consistent with the ACCME definition of continuing medical education (CME). As an ACCME-accredited provider of CME, it is the policy of Med-IQ to review and ensure that all the content and any recommendations, treatments, and manners of practicing medicine in CME activities are scientifically based, valid, and relevant to the practice of medicine. Med-IQ is responsible for validating the content of the CME activities it provides. Specifically, (1) all recommendations addressing the medical care of patients must be based on evidence that is scientifically sound and recognized as such within the profession; (2) all scientific research referred to, reported, or used in CME in support or justification of a patient care recommendation must conform to generally accepted standards of experimental design, data collection, and analysis.

Med-IQ is not liable for any decision made or action taken in reliance upon the information provided through this activity.

Contact Information
For questions or comments about this activity, please contact Med-IQ. Call (toll-free) 866 858 7434 or e-mail info@med-iq.com.

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Med-IQ fully complies with the legal requirements of the ADA and the rules and regulations thereof. If any participant in this educational activity is in need of accommodations, please contact Med-IQ at 443 543 5200.

Disclaimer
The information provided through this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.

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Acknowledgment of Commercial Support
This activity is supported by an educational grant from Gilead Sciences, Inc.

Copyright
© 2015 Med-IQ®. All rights reserved.

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The information provided through this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.

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