For hospitals, treatment of the rising number of multidrug-resistant pathogens continues to challenge pharmacists and physicians.
To help clinicians better understand the current environment for treatment of multidrug resistant organisms (MDROs), Jason Gallagher, PharmD, FCCP, BCPS, will outline some of the more troubling antibiotic-resistant bacterial pathogens facing society and describe approaches in their management in a webinar on July 29. He will focus on areas in which advancements have been made in understanding the optimal treatment of resistant infections. The discussion will include therapies that have been shown to be improvements in treatment as well as practices that promote development of resistant organisms.
Three infectious agents rank among the most troubling MDROs for hospitals, Clostridium difficile (C. diff.), Carbapenem-resistant Enterobacteriaceae (CRE) and drug-resistant Neisseria gonorrhoeae. In 2013, the Centers for Disease Control and Prevention (CDC) named 18 infectious agents as pathogens of concern and categorized these three as urgent threats, the highest level.
C. difficile is unique among these troubling pathogens as it is not currently resistant to antibiotics, but occurs most often in situations of antibiotic use and has high rates of morbidity and mortality. According to the CDC, C. difficile sickens a quarter of a million patients every year and causes 14,000 deaths.
The prevalence of CRE has quadrupled in the last decade, with 4% of acute care hospitals and 18% of long-term care facilities in 42 states now reporting having had a patient infected with either carbapenem-resistant Klebsiella or E. coli.2 The U.S. has 9,300 such cases annually and about 610 reported deaths. CRE infections typically occur in patients who are already seriously ill and they are difficult to treat or, in some case, untreatable. Half of patients with CRE infections in their bloodstreams die.
Drug-resistant Neisseria gonorrhoeae infects nearly 250,000 people in the U.S. each year. Varieties resistant to the four drugs most commonly used to treat it--cefixime, ceftriaxone, azithromycin and tetracyline--now account for 30% of all gonorrheal infections.
Hospitals and healthcare organizations have implemented a variety of programs to limit the spread of these and other multidrug-resistant organisms (MDROs), with mixed results. The webinar will review the methods that have been found to be most effective and the role that pharmacists play in addressing this urgent issue.
Jason Gallagher, Pharm.D., FCCP, BCPS is Clinical Professor at Temple University School of Pharmacy and Clinical Pharmacy Specialist in Infectious Diseases at Temple University Hospital, both in Philadelphia, PA. He also is the Director of the PGY2 Residency in Infectious Diseases Pharmacy at Temple.
Dr. Gallagher is a member of numerous professional organizations including Infectious Diseases Society of America and the American College of Clinical Pharmacy (ACCP). He is the President-Elect of the Society of Infectious Diseases Pharmacists. He is also a past President of the Mid-Atlantic College of Clinical Pharmacy and former Chair of the ACCP Infectious Diseases Practice and Research Network. In addition, Dr. Gallagher serves on professional committees and is a reviewer for journals including Clinical Infectious Diseases, Antimicrobial Agents and Chemotherapy, and the Journal of Antimicrobial Chemotherapy. He is a co-author of three editions of Antibiotics Simplified, co-editor of two editions of Frequently Prescribed Medications – The Drugs You Need to Know, and his work has been published in journals including Pharmacotherapy, Clinical Infectious Diseases, Infectious Diseases in Clinical Practice, Annals of Pharmacotherapy, Expert Opinion on Pharmacotherapy, and BMC Infectious Diseases.
Antibiotic Resistance Threats in the United States, 2013. CDC.
- Stop Infections from Lethal CRE Germs Now. Making Health Care Safer. CDC Vitalsigns. March 2013.