Use of Chronic Antibiotics: What the Evidence Tells Us and What it Doesn’t
• Target audience:
This activity has been designed for general internists and all internal medicine subspecialists who utilize antibiotics in their clinical practices.
• Statement of Need:
o Knowledge: Internists are required to manage a wide range of recurrent infections. Not all internists are able or do remain current on the latest guidelines, pivotal trials, and clinical evidence informing the use of chronic antibiotics in the management of recurrent infections. In many cases this is driven by a lack of awareness of advances and available information.
o Competence: Gap analysis revealed that, across a range of infection types, internists often have a strong understanding of best- practice approaches, but do not consistently apply these in practice. For example, despite evidence supporting the use of chronic antibiotic therapies in certain patients with specific recurrent infections, there has been variable implementation in hospital and community-based practices.
• Learning Objectives:
As a result of actively participating in this activity, the learner will be able to:
o Discuss the role of chronic suppressive antibiotics in the setting of chronic prosthetic joint infections and osteomyelitis
o Assess the utility of suppressive antibiotics in patients with recurring cellulitis
o Evaluate the use of chronic antibiotics in elderly patients with recurrent urinary tract infections
o Review key clinical implications of chronic antibiotic use including emergence of resistance and side effects
o Utilize the data and case information in clinical decision-making
• Principal faculty and their credentials:
Faculty: Mia A. Taormina, DO, FACOI, Chair, Department of Infectious Disease and Travel Medicine, Chair, Infection Control Task Force, Elmhurst, IL
Activity Director: Donald S. Nelinson, PhD, Chief Science & Education Officer, American College of Osteopathic Internists
• Accreditation Statements:
The American College of Osteopathic Internists is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The American College of Osteopathic Internists (ACOI) is accredited by the American Osteopathic Association to provide continuing medical education to physicians.
• Credit Designation Statements:
The American College of Osteopathic Internists designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The American College of Osteopathic Internists designates this enduring material for a maximum of 0.75 AOA Category 1B Credits.
• Release date (or date of most recent review) and expiration date.
This activity opened for learning on 09/01/2020 and expires on 09/01/2021.
• Acknowledgment of commercial support:
This activity received no commercial support.
• Copyright information:
Copyright ©2020 American College of Osteopathic Internists. All Rights Reserved.
• Information on relevant financial relationships for all faculty and planning committee/staff members in control of content:
o Dr. Taormina has disclosed no relevant financial relationships.
o ACOI Chief Science and Education Officer has disclosed no relevant financial relationships.
o ACOI CME Committee Members have disclosed no relevant financial relationships.
• Instructions regarding how to participate in the activity, how to earn credit, and how to obtain a certificate of credit or transcript:
Learners must have an account on the ACOI Online Learning Center in order to access and view educational content. Creation of an account is free and completed by clicking on “Create Account” on the top right of the Learning Center homepage. To participate in this activity, the learner will watch the video. After watching the video, the learner will complete the 5-question post-test. Once the learner completes the learning activity by successfully passing the post-test, s/he will be able to print or save a certificate for his/her records. The learner is responsible for the submission of earned AMA PRA credits to the appropriate entities. If the learner was awarded AMA PRA credit for participation in the live activity, s/he may not claim credit for participation in the enduring material, although we encourage review of the content to reinforce live learning. The type and amount of continuing medical education credit varies by learning activity. Learners are encouraged to view all activity information prior to the purchase of materials to ensure the amount and type of credit available for this specific activity meets educational needs.
• Method of Learner participation in learning process:
In order to obtain credit for this activity, the learner must successfully pass the 5-question post-test. A score of 80% is required to pass.
• Solicit details of intended changes in practice or new/enhanced practice strategies (evaluation survey).
After completing the 5-question post-test, the learner will be asked to complete a 2 question survey on the details of intended changes in practice.
• Bibliographic sources to allow for further study:
o Osmon DR et. al. Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2013;56(1):e1-e25
o Wade D, Cooper J, Derry F, Taylor J. Uro-Vaxom® versus placebo for the prevention of recurrent symptomatic urinary tract infections in participants with chronic neurogenic bladder dysfunction: a randomised controlled feasibility study. Trials. 2019;20(1):223. Published 2019 Apr 16. doi:10.1186/s13063-019-3275-x
o Beerepoot MAJ, ter Riet G, Nys S, et al. Lactobacilli vs antibiotics to prevent urinary tract infection: a randomized, double-blind, noninferiority trial in postmenopausal women. Arch Intern Med. 2012;172(9):704-71
Mia A. Taormina, DO, FACOI
Chair, Department of Infectious Disease
Chair, Department of Infectious Disease - DuPage Medical Group
Chair, COVID Task Force - DuPage Medical Group
Adjunct Clinical Faculty - Midwestern University, Chicago College of Osteopathic Medicine