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Antibiotic Use in Hospitals: More than Skin Deep - A Case Study in Complicated Skin and Skin Structure Infection


Antibiotic Use in Hospitals: More than Skin Deep - A Case Study in Complicated Skin and Skin Structure Infection

Topic: Infectious Diseases
Relevant Terms: CA-MRSA, HA-MRSA, MRSA
Primary Audience: Hospitalists and general internal medicine faculty
Launch Date: 21-Nov-12
Credits: 0.5 AMA PRA Category 1 Credit
Expiration Date: The accreditation for this activity has expired.
Curriculum Name: Antibiotic Use in the Hospitals: An Interactive CME Curriculum for Hospitalists

Learning Objectives

After completing this activity, the participant will demonstrate the ability to:

  1. Identify new antimicrobials that are effective in treating patients with SSTIs. 
  2. Evaluate the microbiology and epidemiology of MDR pathogens at their local hospital.
  3. Develop treatment plans for patients with SSTIs that reduces the chance for increased antimicrobial resistance.


    David J. Rosenberg, MD, MPH, FACP, SFHM (Chief Consultant)
    Associate Chair for Hospital Operations, Department of Medicine
    Section Head, Hospital Medicine
    Assistant Professor of Medicine, Hofstra North Shore LIJ School of Medicine
    Division of General Internal Medicine, North Shore University Hospital
    Manhasset, New York
    Andrew F. Shorr, MD, MPH, FCCP
    Associate Director of Pulmonary and Critical Care
    Washington Hospital Center
    Associate Professor of Medicine
    Georgetown University
    Washington, DC
    Christian E. Sandrock, MD, MPH, FCCP 
    Associate Professor of Clinical Medicine
    Department of Pulmonary & Critical Care Medicine
    University of California Davis Health System
    Deputy Health Officer of Yolo County
    Medical Director, Medical Preparedness Network
    Sacramento, California
    Peer Reviewer:
    Belinda Ostrowsky, MD
    Assistant Professor, Department of Medicine (Infectious Diseases)
    Albert Einstein College of Medicine of Yeshiva University
    Director, Antimicrobial Stewardship Program
    Montefiore Medical Center
    Bronx, New York
    PC                                                                                             MAC
    Internet Explorer (v7 or greater), Google Chrome, or Firefox        Safari, Google Chrome, or Firefox
    This activity is Co-sponsored by Albert Einstein College of Medicine of Yeshiva University and Creative Educational Concepts, Inc., in Joint Sponsorship with RealCME. 

    MEDIUM: CME Enduring Material Online Patient Case


    This activity is designed for hospitalists, internists, and other healthcare professionals interested in the appropriate use of antimicrobial treatments and reduce the chance of further development of resistance.
    The goal of this activity is to provide information and guidance to participants in support of achieving the best clinical outcomes in their patients who present with skin and soft-tissue infections.
    Infections caused by resistant organisms have been found to be associated with a 1.3- to 2-fold increase in morbidity, mortality and cost. Further, health care-associated infections and complicated skin and soft tissue infections (SSTIs) are associated with significantly higher mortality rates and longer, more costly length of hospital stay. According to surveillance data, from 1998-2007 MRSA prevalence has risen from 32.7% in 1998 to 53.8% in 2007 (odds ratio 2.4, 95% CI 2.3-2.5). This continuous rise over the previous decade indicates that there are gaps in practice.
    The "Conflict of Interest Disclosure Policy" of Albert Einstein College of Medicine of Yeshiva University requires that faculty participating in any CME activity disclose to the audience any relationship(s) with a pharmaceutical or equipment company. Any presenter whose disclosed relationships prove to create a conflict of interest, with regard to their contribution to the activity, will not be permitted to present.
    The Albert Einstein College of Medicine of Yeshiva University also requires that faculty participating in any CME activity disclose to the audience when discussing any unlabeled or investigational use of any commercial product, or device, not yet approved for use in the United States.
    The CCME staff of the Albert Einstein College of Medicine of Yeshiva University, the planning staff of RealCME, and the planning and editorial staff of Creative Educational Concepts, Inc. have no conflicts of interest with commercial interests related directly or indirectly to this educational activity.

    All faculty have confirmed that their relationships will not impact their ability to author an unbiased presentation.

    Dr. Rosenberg has disclosed that he serves as a consultant for Pfizer, Forest, Merck and Astellas. He also serves on speakers' bureaus for Pfizer and Merck.

    Dr. Shorr has disclosed that he serves as a consultant for Astellas, Theravance, Forrest, Bayer and Pfizer. He also serves on speakers' bureaus and has received grant/research support from Pfizer and Astellas.

    Dr. Sandrock has disclosed that he serves on speakers' bureaus and as a consultant for Pfizer and Astellas.

    Dr. Ostrowsky (peer reviewer) has indicated that she has no disclosures to report.

    All faculty have indicated that this enduring material does not include the unlabel/investigational use of a commercial product or device.

    This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Albert Einstein College of Medicine of Yeshiva University and RealCME. Albert Einstein College of Medicine of Yeshiva University is accredited by the ACCME to provide continuing medical education for physicians.
    Albert Einstein College of Medicine of Yeshiva University designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    The opinions and recommendations expressed by faculty in this activity are their own and do not necessarily represent the views of Albert Einstein College of Medicine of Yeshiva University, Montefiore Medical Center, Creative Educational Concepts or RealCME.

    Participants are advised to consult prescribing information for all specific drugs or combination of drugs, including indications, contraindications, warnings, and adverse effects, before administering pharmacologic therapy to patients.

    These case discussions offer an opportunity to discuss treatment options, including the use of traditional and newer antimicrobial agents. Your local microbiology and patient population should guide your clinical practice.  If cases have complicated management or dosing issues consider consultation with an infectious diseases specialist and/or clinical pharmacist.

    There are no fees for participating in and receiving credit for this activity. The participant must read the learning objectives, faculty disclosures and enduring material, and must answer the multiple-choice online post-test, and evaluation form which provides each participant with the opportunity to comment on the quality of the instructional process, the perception of enhanced professional effectiveness, the perception of commercial bias, and his/her views on future educational needs.

    Upon successful completion of the post-test with a passing grade of 65%, and the evaluation, physicians will receive CME credit and all other healthcare professionals will receive a certificate of participation. A certificate will be available to print from your user history page.

    November 21, 2012
    TERMINATION DATE: November 20, 2013


    Copyright © 2012 Albert Einstein College of Medicine of Yeshiva University. All rights reserved. No part of this material may be used or reproduced in any manner whatsoever without written permission except in the case of brief quotations.

    Albert Einstein College of Medicine of Yeshiva University, Center for Continuing Medical Education (Einstein) protects the privacy of personal and other information regarding participants and educational collaborators. Einstein will not release personally identifiable information to a third party without the individual's consent, except such information as is required for reporting purposes to the ACCME.

    Einstein maintains physical, electronic, and procedural safeguards that comply with federal regulations to protect against the loss, misuse or alteration of information that we have collected from you.

    Additional information regarding Albert Einstein College of Medicine's Privacy Policy can be viewed at

    If you have questions about this CME activity, please contact Albert Einstein College of Medicine of Yeshiva University at 1-718-920-6674 or

    This activity is supported by educational grants from Pfizer Inc. and Astellas Pharma Global Development, Inc.