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Emerging Infections and Antibiotic Resistance

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Overview

Resistant organisms, once confined to hospitals, are now being transmitted in the community. Initially reported in the 1980s, community-onset infections caused by these resistant organisms are an emerging public health concern. These infections contribute to escalating healthcare costs and in some cases, increased mortality.

The media have highlighted MRSA in the community, referring to it as a “superbug.” Its transmission through close contact has increased the incidence of skin and soft tissue infections. Similar to MRSA, ESBL-producing Enterobacteriaceae were initially reported as hospital pathogens and are now found in the community as distinct clones. These infections are most often urinary tract infections caused by Escherichia coli that are resistant to the antibiotics typically used for empiric treatment. Also concerning is the escalating prevalence of C. difficile infection (CDI) in the community. In contrast to MRSA and ESBL-producing Enterobacteriaceae, this microbe is usually not antibiotic resistant. However, annual CDI death rates in the U.S. increased from about 6 per million people in 1999 to 24 per million in 2004.

This issue reviews the risk factors and outpatient treatment challenges for each of the infections listed above. Currently recommended antibiotic regimens are discussed in detail.

Details

Publication Date: 06/01/2011
Expiration Date: 06/01/2014
CE Credit: 1.5 (0.15 CEU)
Type of Activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.

Authors

Trisha S.M. Tom, PharmD, BCPS

Disclosure Statement

Dr. Trisha Tom reports no financial or personal relationship with any commercial interest producing, marketing, reselling, or distributing a product or service that appears in this issue.

Target Audience

This accredited program is targeted to pharmacists and nurses.

Goals & Objectives

At the conclusion of this program, participants will be able to:

  • List strategies that may help prevent antibiotic resistance.
  • Distinguish between community-associated and hospital-associated methicillin-resistant Staphylococcus aureus (MRSA).
  • For the following bacteria emerging in the community, CA-MRSA, extended spectrum betalactamase (ESBL)-producing Enterobacteriaceae, and Clostridium difficile: (a) identify risk factors for infection, (b) describe the usual infection(s) caused by the bacteria, and (c) recommend antibiotic therapy and list the common side effects and potential drug interactions.

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc. Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a provider of continuing pharmacy education.

Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.

Exam & Credit Statement Procedures

Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Editorial and Review Board

Editor and CE Administrator

Terry M. Baker, PharmD

Associate Editor and CE Coordinator

Tracy Farnen, PharmD

Associate Editors

James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Kaiser Permanente
Oakland, CA

Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA

Ron Finley, RPh
Lecturer
Department of Clinical Pharmacy
University of California San Francisco
San Francisco, CA

Associate Member of the UCSF Memory and Aging Center
Alzheimer's Research Center

Consultant Pharmacist to the Institute on Aging-On Lok Senior Health
Institute on Aging Alzheimer's Day Care Center

Angie S. Graham, PharmD
Drug Information Coordinator
Stanford Hospital and Clinics
Stanford University Medical Center
Stanford, CA

Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System

Adjunct Clinical Professor
College of Pharmacy
Touro University
Vallejo, CA

Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA

Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Stockton, CA

Visiting Associate Professor and Lecturer
Nursing School
Samuel Merritt University
Oakland, CA

Pamela Mausner, MD

Joshua J. Neumiller, PharmD, CDE, CGP, FASCP
Assistant Professor
Department of Pharmacotherapy
College of Pharmacy
Washington State University
And
Elder Services of Spokane
Spokane, WA

Candy Tsourounis, PharmD
Professor of Clinical Pharmacy
Medication Outcomes Center
Department of Clinical Pharmacy
School of Pharmacy
University of California, San Francisco
San Francisco, CA

Senior Editorial Advisor

Gerard Hatheway, PharmD, PhD

Editorial Advisors

Jocelyn Chan, PharmD
Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD


Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners

Emily K. Meuleman, RN, C, MS

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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