Accreditation Statement

Boston University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education (CME) for physicians.

Credit Designation

Boston University School of Medicine designates this educational activity for a maximum of 1.75 AMA PRA Category 1 Credit(s). Physicians should only claim credit commensurate with the extent of their participation in the activity.

CME credit will be awarded provided this activity is used and completed according to instructions and a score of >70% is achieved. A certificate of credit will be sent within 6 weeks of receipt of the test answers to those who successfully complete the examination.

To successfully complete this activity, participants are required to read the entire supplement and complete and submit the test answer sheet. The estimated time to review the supplement and complete the accompanying test is 1.45 h.

Target Audience

This educational activity is intended for physicians treating infectious diseases.

Program Overview

The increasing prevalence of methicillin-resistant Staphylococcus aureus (MRSA) has required that more health care resources be used for treatment of MRSA infections, which can cause significant morbidity and mortality. Treating hospital- and community-acquired MRSA is a challenge to physicians, in part because of the limited number of antibiotics with activity against MRSA isolates, which are characterized by multidrug resistance. Accurate characterization of these isolates can have very important implications for successful patient care. Participants in this educational program will gain insight into critical issues related to characterizing MRSA isolates and treating infections caused by MRSA.

Learning Objectives

At the conclusion of this activity, participants will be able to

1. Assess the factors contributing to the increasing incidence of MRSA in hospitals and communities and characterize some of the differences between strains that are usually found in these settings

2. Identify virulence factors found in MRSA isolates

3. Understand what properties contribute to reduced susceptibility and resistance of MRSA to vancomycin

4. Review the efficacy data for antibiotics used in the treatment of MRSA complicated skin and skin-structure infections

5. Identify the clinical syndromes found in patients with MRSA pneumonia, as well as the antibiotics used to treat it

6. Describe treatment and management strategies for MRSA bacteremia

Release and Expiration Dates

Release date: 1 June 2008. Expiration date: 1 June 2009.

Disclaimer

These materials and all other materials provided in conjunction with CME activities are intended solely for the purposes of supplementing CME programs for qualified health care professionals. Anyone using the material assumes full responsibility and all risk for their appropriate use. Trustees of Boston University makes no warranties or representations whatsoever regarding the accuracy, completeness, currentness, noninfringement, merchantability, or fitness for a particular purpose of the materials. In no event will Trustees of Boston University be liable to anyone for any decision made or action taken in the reliance on the materials. In no event should the information in the materials be used as a substitute for professional care.

Faculty Disclosures

Disclosure policy. Boston University School of Medicine asks all individuals involved in the development and presentation of CME activities to disclose all relationships with commercial interests. This information is disclosed to CME activity participants. Boston University School of Medicine has procedures to resolve apparent conflicts of interest. In addition, faculty members are asked to disclose when any discussion of unapproved use of pharmaceuticals and devices is being discussed.

Author disclosures. Arnold S. Bayer, MD (Associate Chief, Adult Infectious Diseases, Harbor-UCLA Medical Center, and Professor of Medicine, Geffen School of Medicine at UCLA, Los Angeles, CA) has received research support from Pfizer, Johnson & Johnson, Targanta, Novozyme, Titan, Cerexa, Cumbre, and Inhibitex and is a consultant for Pfizer, Inhibitex, and Cubist Pharmaceuticals. Dr. Bayer does not discuss unlabeled/investigational uses of a commercial product.

Helen W. Boucher, MD (Director, Infectious Disease Fellowship Program, Tufts-New England Medical Center, Boston, MA), serves as an advisor/consultant to Biogen Idec, Cubist Pharmaceuticals, Johnson & Johnson, Pfizer, Schering-Plough, Astella/Theravance, and Targanta Therapeutics; as a speaker for Cubist Pharmaceuticals, Pfizer, and Schering-Plough; and owns or has owned shares of Pfizer and Cubist Pharmaceuticals. Dr. Boucher does not discuss unlabeled/investigational uses of a commercial product.

Henry F. Chambers, MD (Professor of Medicine, San Francisco General Hospital, San Francisco, CA), has received research support from Ortho-McNeil and Cubist Pharmaceuticals; is a consultant for Pfizer, Ortho-McNeil, and Theravance; and has received honoraria from Cubist Pharmaceuticals. Dr. Chambers discusses unlabeled/investigational uses of a commercial product.

G. Ralph Corey, MD (Professor, Duke University Medical Center, Durham, NC), serves as an advisor/consultant to Cubist Pharmaceuticals, Inhibitex, Innocoll Pharmaceuticals, Forest Pharmaceuticals, Johnson & Johnson, Merck, Pfizer, Thera-vance, Cypress Pharmaceutical, and United Therapeutics. Dr. Corey does not discuss unlabeled/investigational uses of a commercial product.

Sara E. Cosgrove, MD, MS (Assistant Professor of Medicine, Johns Hopkins University, Baltimore, MD), has served as advisor/consultant to Cubist Pharmaceuticals, Theravance-Astellas, and Cadence and has received a grant from Merck. Dr. Cosgrove discusses unlabeled/investigational uses of a commercial product.

Vance G. Fowler, Jr, MD, MHS (Associate Professor, Duke University Medical Center), has served as an advisor/consultant to Biosynexus, Cerexa, Cubist Pharmaceuticals, Inhibitex, Johnson & Johnson, and Merck; has received grants and research support from Cubist Pharmaceuticals, Inhibitex, Merck, Nabi Biopharmaceuticals, the National Institutes of Health, and Theravance; and is on the speakers bureau for Cubist Pharmaceuticals and Pfizer. Dr. Fowler discusses unlabeled/investigational uses of a commercial product.

Rachel J. Gordon, MD, MPH (Instructor in Clinical Medicine, Division of Infectious Diseases, Columbia University College of Physicians and Surgeons, New York, NY), reports no conflict of interest. Dr. Gordon does not discuss unlabeled/investigational uses of a commercial product.

Adolf W. Karchmer, MD (Chief, Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA) has served as a consultant for Pfizer, Cubist Pharmaceuticals, Theravance-Astellas, Merck, and Ortho-McNeil; has received research grants from Pfizer and Merck; and owns stock in Pfizer and Cubist Pharmaceuticals. Dr. Karchmer does not discuss unlabeled/investigational uses of a commercial product.

Marin H. Kollef, MD, FACP, FCCP (Professor of Medicine, Washington University School of Medicine, St. Louis, MO), is a speaker for Pfizer, Merck, and Elan Corporation; and is a consultant for C. R. Bard (Medical Division) and Johnson & Johnson. Dr. Kollef discusses unlabeled/investigational uses of a commercial product.

Franklin D. Lowy, MD (Professor of Medicine and Pathology, Columbia University College of Physicians and Surgeons, New York, NY), has received research support from Cubist Pharmaceuticals, GlaxoSmithKline, and Pfizer; and has been on advisory panels for Pfizer, Nabi Biopharmaceuticals, and Wyeth. Dr. Lowy does not discuss unlabeled/investigational uses of a commercial product.

Robert C. Moellering, Jr., MD (Chairman, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA), has served as an advisor/consultant to Cubist Pharmaceuticals, Johnson & Johnson, Ortho-Clinical Diagnostics, Pfizer, Targanta Therapeutics, Theravance, and Wyeth. Dr. Moellering does not discuss unlabeled/investigational uses of a commercial product.

Dilip Nathwani, MB, FRCP (Consultant Physician, Infection Unit, Ninewells Hospital & Medical School, Dundee, Scotland), has served on advisory boards for Johnson & Johnson, Wyeth, Novartis, and Optimer Pharmaceuticals; and has received speakers' fees from Novartis, Johnson & Johnson, Pfizer, and Wyeth. Professor Nathwani discusses unlabeled/investigational uses of a commercial product.

Ethan Rubinstein, MD, LLB (Professor of Medicine, University of Manitoba, Winnipeg, Canada), is an advisor to Pfizer, Bayer, Schering-Plough, Wyeth, Astellas Pharma, King Pharmaceuticals, Atox-Bio, Theravance, and Teva Pharmaceutical Industries; received research grants from Daiichi Sankyo, Thera-vance, and Wyeth; and has received speakers' fees from Thera-vance, Wyeth, and Pfizer. Dr. Rubinstein discusses unlabeled/investigational uses of a commercial product.

George Sakoulas, MD (Assistant Professor of Medicine, New York Medical College, Valhalla, NY) is on the speakers bureau of Cubist Pharmaceuticals, Pfizer, Merck, and Wyeth; has received research grant support from Cubist Pharmaceuticals; and has served as advisor/consultant to Cubist Pharmaceuticals and Pfizer. Dr. Sakoulas does not discuss unlabeled/investigational uses of a commercial product.

Martin E. Stryjewski, MD (Co-Investigator and Physician in Infectious Diseases, Cemic Hospital, Buenos Aires, Argentina), has received a research grant from and is a consultant for Theravance and has received honoraria from Astellas. Dr. Stryjewski discusses unlabeled/investigational uses of a commercial product.

Course director disclosures. Stephen I. Pelton, MD (Professor of Pediatrics, Boston University School of Medicine, and Chief, Division of Pediatric Infectious Diseases, Boston Medical Center, Boston, MA), has received grant/research support from Sanofi Pasteur and Wyeth; is a consultant for GlaxoSmithKline; and is on the speakers' bureau for Sanofi Pasteur and the advisory boards for Sanofi Pasteur and Wyeth.

Program manager disclosures. Elizabeth Gifford (Program Manager, Boston University School of Medicine Continuing Medical Education) has nothing to disclose.

David DeVellis, MD (Senior Medical Director, ApotheCom Associates LLC, Wakefield, MA), has nothing to disclose.