Drug Topics - May 12, 2008 - (Page 64)

64 DRUG TOPICS MAY 12, 2008 www.drugtopics.com CONTINUING EDUCATION An ongoing CE program of The University of Florida College of Pharmacy and DRUG TOPICS Antimicrobial resistance among community pathogens Allana Mehlhorn, Associate Professor of Pharmacy Practice Elias Chahine, Assistant Professor of Pharmacy Practice Allison Butcher, Assistant Professor of Pharmacy Practice Lloyd L. Gregory School of Pharmacy, Palm Beach Atlantic University Staphylococcus aureus (MRSA) left the hospital a decade ago, penicillin-resistant Streptococcus pneumoniae (PRP) have spread widely, and there have already been reports of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli in the community. The alarming increase in antimicrobial resistance in the face of a drastic decline in the development of new antimicrobial agents may lead to a public health crisis. In the United States, healthcare costs associated with multi-drug resistance have been estimated to be several billion dollars. In addition to an increased cost of treatment, antimicrobial resistance is associated with a heightened risk of treatment failure and greater patient morbidity and mortality. This article reviews the mechanisms of antimicrobial resistance, highlights important microbial pathogens found in the community setting, discusses antimicrobial options for the treatment of resistant pathogens, and provides strategies to reduce antibiotic resistance. CE The University of Florida College of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education ACPE # 012-99908-072-H01-P ACPE # 012-99908-072-H01-T This lesson is no longer valid for CE credit after 5/31/10. To obtain immediate CE credit, take the test online at www.drugtopics.com. Just click on the “Continuing Education” box on the Drug Topics home page, which will take you to the CE site. Log in, find and click on this lesson, and follow the three simple steps. Test results will be displayed immediately and you can print the certificate showing your earned CE credits. T For questions concerning PRINT CEs, call (352) 273-6275. For questions concerning ON-LINE CEs, call (866) 261-3558. Photo: Steve Cole/Photodisc/Getty Images he emergence of strains of microorganisms that are resistant to commonly used anti-infectives has become a global issue. Traditionally considered to be a hospital problem, antimicrobial resistance is now affecting pathogens in the community setting. When penicillin was introduced in the 1940s, some clinicians thought that they had won the battle against bacteria, but the reality is that only two pathogens remain routinely susceptible to penicillin: Streptococcus pyogenes, the microbial etiology of strep throat and certain skin infections, and Treponema pallidum, the microorganism that causes syphilis. Methicillin-resistant Drivers of resistance in the community Overuse and inappropriate use of antimicrobials have contributed to the development of resistance in both the inpatient and outpatient settings. As opposed to the inpatient setting, culture and susceptibility methods are often not readily available in the community setting. Thus, clinicians tend to prescribe broad-spectrum empiric antibiotic agents for entire courses of therapy and often do not de-escalate therapy. The impact of the empiric use of broad-spectrum agents was analyzed in one study that reviewed the appropriateness of fluoroquinolone use in the emergency depart- http://www.drugtopics.com http://www.drugtopics.com.www.drugtopics.com

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Drug Topics - May 12, 2008 Contents Latebreakers Letters R.Ph.s Say More Needs to be Done to Prevent Pediatric Drug Errors There's a New School of Thought on Use of Beta-Blockers for Hypertension Cover Story Guest Spot Letters Clinical Practice Special Report Professional Practice Broad Label for New Leukemia Therapy Looks Promising Treating Asthma During Pregnancy Safer than Not, Says New Guide In the Pipeline Clinical Q&A APhA Leader's Plan to Leave Office Takes Center Stage at its Conference Policies Passed at a Glance Giving a Talk to the Community? Check Out These Materials This Foundation has Funds to Spare JP at Large Cover Story: Employers and R.Ph.S: A Win-Win Combo FDA's Ilisa Bernstein Discusses Pharmacy Affairs Legal Q&A Manufacturers Unleash a Rash of Poison Ivy Treatments Are OTC Cold Remedies Safe for Kids? Probiotics are All the Rage: How You Can Capitalize on It CMS' Prices for Round One of DMEPOS Competitive Bidding Raising Concerns CVS Caremark's Mentoring Program Recruits and Retains R.Ph.s Antibiotic Resistance Among Community Pathogens Technology Update New Products Advertisers Index Classified Viewpoint

Drug Topics - May 12, 2008

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