Overview
The Challenges of Invasive Fungal Infections in Community Hospitals
A CME Guidebook to Improve Therapy and Clinical Outcomes
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This interactive digital guidebook addresses the unique challenges of the community hospital to aid community practitioners, emergency-department physicians, critical-care physicians, hematologists, oncologists, and transplant surgeons in the treatment of patients with invasive fungal infections (IFIs), particularly in immunocompromised or immunosuppressed patients. Chapter topics include the epidemiology and burden of IFIs, ensuring a timely and accurate diagnosis, and the selection of appropriate antifungal therapy across diverse patients with IFIs.
This activity is intended for community practitioners, emergency-department physicians, critical-care physicians, oncologists, hematologists, transplant specialists, and other members of the healthcare team, especially those in the community hospital setting.
The management of invasive fungal infections (IFI) is centered on establishing an early and reliable diagnosis. Early diagnosis allows timely initiation of antifungal agents, yet challenges exist, such as access to prompt antifungal susceptibility testing. Due to challenges with diagnostic uncertainty, inappropriate prescribing of antifungal agents results. These unnecessary treatments result in toxicities, resistance, and cost implications, as well as unnecessary morbidity/mortality. Recent guidelines for the management of IFI have been released, yet awareness and adherence to guideline recommendations is suboptimal. Even so, many aspects of IFI management require clinical judgement and may not be supported by evidence, whereby a multidisciplinary discussion and expert opinion provide critical guidance for community clinicians.
Upon completion of these educational activities, learners should be able to:
• Identify patients who have a high-risk of IFIs and those who require preemptive therapy or prophylaxis
• Discuss available diagnostic tests and emerging technologies to ensure early detection of IFIs
• Select antifungal therapy based on clinical presentation and susceptibility testing
• Outline considerations in the toxicity, pharmacokinetic/pharmacodynamic profiles, and monitoring of antifungal agents for diverse patients with IFIs
• Identify patients who have a high-risk of IFIs and those who require preemptive therapy or prophylaxis
• Discuss available diagnostic tests and emerging technologies to ensure early detection of IFIs
• Select antifungal therapy based on clinical presentation and susceptibility testing
• Outline considerations in the toxicity, pharmacokinetic/pharmacodynamic profiles, and monitoring of antifungal agents for diverse patients with IFIs
Sponsored by the Academy for Continued Healthcare Learning (ACHL).
Supported by an independent educational grant from Astellas.
Peter G. Pappas, MD
Professor of Medicine
Principal Investigator, Mycoses Study Group
Division of Infectious Diseases
Department of Medicine
University of Alabama at Birmingham
Birmingham, Alabama
Professor of Medicine
Principal Investigator, Mycoses Study Group
Division of Infectious Diseases
Department of Medicine
University of Alabama at Birmingham
Birmingham, Alabama
James Lewis, II, PharmD, FIDSA
Infectious Disease Clinical Pharmacy Supervisor
Co-Director of Antibiotic Stewardship
Department of Pharmacy
Oregon Health & Science University
Portland, Oregon
George Thompson, MD
Associate Professor of Medicine
Medical Microbiology and Immunology
Division of Infectious Diseases
University of California, Davis
Sacramento, California
The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in a CME activity disclose all affiliations or other financial relationships (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. All conflicts of interest have been resolved prior to this CME activity.
The following financial relationships have been provided:
Peter Pappas, MD (Faculty)
Research Grant: Astellas, Gilead, IMMY, Merck, and Scynexis
James Lewis, PharmD (Faculty)
Consultant: Accelerate Diagnostics, Achaogen, Merck, Tetraphase Pharmaceuticals, and The Medicines Company
George Thompson, MD (Faculty)
Types of financial relationships: None
Discussion of Off-Label, Investigational, or Experimental Drug/Device Use: This activity discusses off-label use of posaconazole in the context of mucormycosis in patients with diabetic ketoacidosis who may be at risk of acute renal failure.
ACHL staff members and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.
The content for this activity was developed independently of the commercial supporter. All materials are included with permission. The opinions expressed are those of the faculty and are not to be construed as those of the publisher or grantor.
This educational activity was planned and produced in accordance with the ACCME Accreditation Criteria, Policies, and Standards for Commercial Support. Recommendations involving clinical medicine in a continuing medical education (CME/CE) activity must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported, or used in CME/CE in support or justification of a patient care recommendation must conform to the generally accepted standards of experimental design, data collection, and analysis.
This CME/CE activity might describe the off-label, investigational, or experimental use of medications and/or devices that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers’ prescribing information for these products. ACHL requires the speaker to disclose that a product is not labeled for the use under discussion.
This activity will take approximately 90 minutes to complete. To receive credit, participants are required to view the digital guidebook and complete the posttest and evaluation. To receive credit, 60% must be achieved on the posttest. A certificate will be immediately available. There is no fee to participate in the activity or for the generation of the certificate.
For questions, contact Katlyn Cooper at kcooper@achlcme.org.
The Academy for Continued Healthcare Learning is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The Academy for Continued Healthcare Learning designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.