Antimicrobial Stewardship: Improving Clinical Outcomes by Optimization of Antibiotic Practices

Monday, April 16, 2018, 12:00 AM - Tuesday, April 16, 2024, 12:00 AM PST, Online Course

Internet Enduring Material Jointly Provided by Stanford University School of Medicine (CME) and University of Rhode Island College of Pharmacy. Presented by the Division of Infectious Diseases and Geographic Medicine at Stanford University School of Medicine. Sponsored by the Stanford University School of Medicine.

Antibiotics are among the most frequently prescribed classes of drugs and it is estimated that approximately 50% of antibiotic use, in both the outpatient and inpatient settings, is inappropriate. At the same time, in contrast to any other class of drugs, every antibiotic use has a potential public health consequence – inappropriate use may not harm only the individual patient, but contributes to societal harm by exerting an unnecessary selective pressure that may lead to antibiotic resistance among bacteria. This video based course will introduce learners to the basic principles of appropriate antibiotic use, demonstrate how to apply these principles to the management of common infections, and outline how to develop and maintain an antimicrobial stewardship program. We will offer a number of illustrative cases, recognizable to the practicing physician in his or her practice to engage learners in the thought processes that lead to optimal decision making, improved outcomes of individual patients, and harm reduction vis-a-vis the bacterial ecology. The course will also explore strategies to implement principles of antimicrobial stewardship both in your practice and also at a program level.

Intended Audience

This course will offer a practical approach to prescribing antibiotic therapy and development of antimicrobial stewardship to physicians and pharmacists across all specialties and settings.

Release Date: April 16, 2018
Latest Review Date: April 16, 2021
Expiration Date: April 16, 2024
Estimated Time to Complete: 7.00 hours
Registration Fee: FREE

AMA PRA Category 1 Credits™ (7.00 hours), Non-Physician Participation Credit (7.00 hours)

1. Apply IDSA guidelines in treating infections such as acute rhino-sinusitis, cystitis and acute bronchitis.
2. Incorporate guidelines/standardized protocols to diagnose and prescribe antibiotic therapy for treating sepsis.
3. Develop strategies to implement evidence based practices for antimicrobial stewardship in your practice setting.
4. Develop a plan to lead an antimicrobial stewardship program.

In support of improving patient care, Stanford Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

<<if Jointly Providership>> In support of improving patient care, this activity has been planned and implemented by Stanford Medicine and . Stanford Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 
 
Credit Designation 
American Medical Association (AMA) 
Stanford Medicine designates this Enduring Material for a maximum of 7.00 AMA PRA Category 1 Credits^TM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Accreditation Council of Pharmacy Education (ACPE) 
Stanford Medicine designates this knowledge-based activity for a maximum of [insert number] hours. Credit will be provided to NABP CPE Monitor within 60 days after the activity completion.

American Nurses Credentialing Center (ANCC) 
Stanford Medicine designates this [insert learning format] activity for a maximum of [insert number] ANCC contact hours.  

ASWB Approved Continuing Education Credit (ACE) – Social Work Credit 
As a Jointly Accredited Organization, Stanford Medicine is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. Stanford Medicine maintains responsibility for this course. Social workers completing this activity receive [insert number] [insert learning format] continuing education credits. 

American Academy of Physician Assistants (AAPA) - Live 
Stanford Medicine has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This live activity is designated for [insert number] AAPA Category 1 CME credits. PAs should only claim credit commensurate with the extent of their participation.  

American Academy of Physician Assistants (AAPA) - Enduring Materials 
Stanford Medicine has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This enduring activity is designated for [insert number] AAPA Category 1 CME credits. Approval is valid until {Expiration Date}. PAs should only claim credit commensurate with the extent of their participation. 

American Psychological Association (APA) 
Continuing Education (CE) credits for psychologists are provided through the co-sponsorship of the American Psychological Association (APA) Office of Continuing Education in Psychology (CEP). The APA CEP Office maintains responsibly for the content of the programs. 

<<For activities with AMA PRA Category 1 Credit and approved for MOC only>>
American Board of Anesthesia MOC Credit 
This activity contributes to the CME component of the American Board of Anesthesiology’s redesigned Maintenance of Certification in Anesthesiology^TM (MOCA®) program, known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 requirements. 

American Board of Internal Medicine MOC Credit 
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 7.00 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

American Board of Ophthalmology MOC/CC Credit 
Successful completion of this CME activity, which includes participation in the evaluation component, earns credit toward Lifelong Learning [, Self-Assessment, Improvement in Medical Practice and/or Patient Safety] requirement[s] for the American Board of Ophthalmology’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting MOC credit.  

American Board of Otolaryngology – Head and Neck Surgery MOC Credit
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn their required annual part II self-assessment credit in the American Board of Otolaryngology – Head and Neck Surgery’s Continuing Certification program (formerly known as MOC). It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of recognizing participation. 

American Board of Pathology MOC Credit
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 7.00 Lifelong Learning MOC points in the American Board of Pathology’s (ABPath) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABPath MOC credit.

American Board of Pediatrics MOC Credit 
Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn up to 7.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit learner completion information to ACCME for the purpose of granting ABP MOC credit.

American Board of Surgery MOC/CC Credit 
Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.  

MOC Participation Threshold

Learner participates in verbal or chat-based case discussion/conversation as judged by a group leader or observer.

 

Learner completes answers to a quiz, percent of correct answers required will be set by provider.

Learner writes a reflective statement and makes a commitment to change or maintain an element of practice. Validity of all written statements will be assessed prior to awarding credit.

Learners engage adequately to select answers to questions using the ARS. Threshold set by provider.

Learner participates in the table-top discussion and writes a possible next step to each question/set point in discussion. Judged by a group leader or observer.

Learner participates in simulation as judged by a facilitator or observer.

Cultural and Linguistic Competency
The planners and speakers of this CME activity have been encouraged to address cultural issues relevant to their topic area for the purpose of complying with California Assembly Bill 1195. Moreover, the Stanford University School of Medicine Multicultural Health Portal contains many useful cultural and linguistic competency tools including culture guides, language access information and pertinent state and federal laws. You are encouraged to visit the Multicultural Health Portal: http://lane.stanford.edu/portals/cultural.html

Bibliography
CDC. Antibiotic Resistance Threats in the United States, 2013. http://www.cdc.gov/drugresistance/threat-report-2013/

BarlamTF, Cosgrove SE, AbboLM, et al. Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. ClinInfect Dis. 2016; 62:e51-77

CDC. Core Elements of Hospital Antibiotic Stewardship Programs. http://www.cdc.gov/getsmart/healthcare/implementation/core-elements.html

For a complete list, please view the References/Bibliography page of the Course 

Disclosures

The following planners, speakers, and reviewers have indicated that they have no relationships with industry to disclose relative to the content of this activity.

• Stan Deresinski, MD, FIDSA 
  Clinical Professor of Infectious Diseases
  Director of Antimicrobial Stewardship Program
  Stanford University School of Medicine
  Course Director
  Speaker
  
• Marisa Holubar, MD, MS
  Clinical Assistant Professor of Infectious Diseases
  Associate Director of Stanford Antimicrobial Safety and Sustainability Program
  Stanford University School of Medicine
  Course Director
  Speaker
  Reviewer
  
• Emily Mui, PharmD, BCPS
  Infectious Disease Pharmacist, Antimicrobial Stewardship Program
  Stanford University School of Medicine
  Course Director
  Speaker
  
• Elizabeth Robilotti, MD, MPH
  Associate Director, Infection Control Program
  Memorial Sloan Kettering Cancer Center, New York, NY
  Course Director
  Speaker
  
• Niaz Banaei, MD
  Associate Professor of Pathology and Medicine (Infectious Diseases)
  Stanford University School of Medicine
  Speaker
  
• Raj Behal, MD, MPH 
  Chief Quality Officer
  One Medical Group, San Francisco 
  Speaker
• Kristi Kuper, PharmD, BCPS
  Senior Clinical Manager of Infectious Disease
  Vizient Inc., Irving, TX 
  Speaker
  
• Anne Liu, MD
  Clinical Assistant Professor of Pediatrics - Immunology and Allergy
  Clinical Assistant Professor of Infectious Diseases
  Pediatric Allergy & Immunology Clinic
  Stanford University School of Medicine
  Speaker
  
• Preeti N. Malani, MD, MSJ, MS
  Professor of Infectious Diseases 
  University of Michigan Health System, Ann Arbor, MI
  Speaker
• Jason Newland, MD, MEd, FPIDS 
  Associate Professor of Pediatrics
  Washington University in St. Louis 
  Director of Antimicrobial Stewardship Program
  St. Louis Children’s Hospital, St. Louis, MO 
  Speaker
  
• Susan Seo, MD 
  Associate Professor of Clinical Medicine
  Weill Cornell Medical College 
  Director of Antibiotic Management Program
  Memorial Sloan Kettering Cancer Center, New York, NY 
  Speaker
• Edward A. Stenehjem, MD, MSc 
  Associate Professor of Medicine in the Division of Infectious Diseases
  Medical Director of Antimicrobial Stewardship
  Intermountain Medical Center, Salt Lake City, Utah 
  Speaker
  
• Kavita Trivedi, MD 
  Adjunct Clinical Assistant Professor
  Stanford University School of Medicine
  Founder
  Trivedi Consults LLC, Berkeley, CA
  Speaker
  
• Danilo Lo Fo Wong, PhD 
  Programme Manager Control of Antimicrobial Resistance Communicable Disease and Health Security 
  WHO Regional Office for Europe, Copenhagen, Denmark 
  Speaker
  
• The following planner and speakers have indicated that they have relationships with industry to disclose relative to the content of this activity.
• Thomas M File Jr., MD, MSc, MACP, FIDSA, FCCP
  Professor of Internal Medicine
  Northeastern Ohio Universities College of Medicine 
  Chief of the Infectious Disease Service and Director of HIV Research
  Summa Health System, Akron, OH 
  Speaker 
  Advisory Board Member: Allergan, Pfizer Inc., GlaxoSmithKline, The Medicine's Co., Merck, MotifBio 
  Consulting: Paratek, Shionogi Inc. 
• Conan MacDougall, PharmD, MAS, BCPS
  Professor of Clinical Pharmacy
  University of California San Francisco School of Pharmacy, SF, CA
  Speaker 
  Consulting: Shionogi Inc.
• Lina Meng, PharmD, BCPS, BCCP
  Antimicrobial Stewardship Pharmacist
  Stanford Hospital and Clinics
  Course Director
  Speaker 
  Ownership Interest: Gilead

Stanford University School of Medicine has received and has used undesignated program funding from Pfizer, Inc. to facilitate the development of innovative CME activities designed to enhance physician competence and performance and to implement advanced technology. A portion of this funding supports this activity.