CME: Pathogen-Directed Respiratory Infection Care

CME: Pathogen-Directed Respiratory Infection Care

Antimicrobial resistance poses a serious public health threat and is an especially challenging issue when treating respiratory infections. Research shows that the number of pneumonia cases caused by antibiotic-resistant bacteria has risen substantially in recent years. These cases have been linked to higher mortality and morbidity, longer stays in intensive care, and increased costs due to inadequate therapy when compared with pneumonia caused by non-resistant pathogens. “We’re in the middle of an antimicrobial resistance crisis in the United States,” says Helen W. Boucher, MD, FACP, FIDSA. “One of the biggest contributors to this issue is the overuse of antibiotics. Some clinicians are treating infections too broadly and prescribing unwarranted antibiotics. Although many respiratory infections are caused by viruses, antibiotics are often prescribed inappropriately to treat these infections.”   The Challenge As with any infection, respiratory infections should be treated as narrowly as possible, according to Dr. Boucher, who co-authored a review article summarizing the current state of antimicrobial-resistant bacterial respiratory tract pathogens (Table) that was published in Current Opinion in Pulmonary Medicine. “The goal is to treat the exact pathogen that’s causing the infection, and nothing more. Treating beyond a specific pathogen can lead to overuse of antibiotics, resistance, and adverse effects for patients,” she says. Dr. Boucher says strong, accurate diagnostic testing is required in order to appropriately prescribe antibiotics. “For pneumonia,” she says, “there are several new tools that are highly accurate in diagnosing the pathogen causing the infection. This allows for appropriate, pathogen-directed therapy. Pathogen-directed therapy also includes recognizing if the bacterium is susceptible or resistant to certain antibiotics.” Even when these factors are known, targeting...
Pathogen-Directed Respiratory Infection Care

Pathogen-Directed Respiratory Infection Care

Antimicrobial resistance poses a serious public health threat and is an especially challenging issue when treating respiratory infections. Research shows that the number of pneumonia cases caused by antibiotic-resistant bacteria has risen substantially in recent years. These cases have been linked to higher mortality and morbidity, longer stays in intensive care, and increased costs due to inadequate therapy when compared with pneumonia caused by non-resistant pathogens. “We’re in the middle of an antimicrobial resistance crisis in the United States,” says Helen W. Boucher, MD, FACP, FIDSA. “One of the biggest contributors to this issue is the overuse of antibiotics. Some clinicians are treating infections too broadly and prescribing unwarranted antibiotics. Although many respiratory infections are caused by viruses, antibiotics are often prescribed inappropriately to treat these infections.”   The Challenge As with any infection, respiratory infections should be treated as narrowly as possible, according to Dr. Boucher, who co-authored a review article summarizing the current state of antimicrobial-resistant bacterial respiratory tract pathogens (Table) that was published in Current Opinion in Pulmonary Medicine. “The goal is to treat the exact pathogen that’s causing the infection, and nothing more. Treating beyond a specific pathogen can lead to overuse of antibiotics, resistance, and adverse effects for patients,” she says. Dr. Boucher says strong, accurate diagnostic testing is required in order to appropriately prescribe antibiotics. “For pneumonia,” she says, “there are several new tools that are highly accurate in diagnosing the pathogen causing the infection. This allows for appropriate, pathogen-directed therapy. Pathogen-directed therapy also includes recognizing if the bacterium is susceptible or resistant to certain antibiotics.” Even when these factors are known, targeting...
CME: Pneumonia & CVD: Making the Link

CME: Pneumonia & CVD: Making the Link

Studies have shown that patients with respiratory tract infections (RTIs) often have higher risk for cardiovascular events than those without RTIs. However, these studies have mostly assessed risk within the first few months after an RTI. Investigations that have assessed long-term risk have had conflicting results. By better characterizing the short- and long-term risks of CVD after an RTI, clinicians may be able to clarify whether these infections are risk factors for CVD and help explain the short- and long-term morbidity and mortality among patients with RTIs. Assessing Risk For a study published in JAMA, Sachin Yende, MD, MS, and colleagues examined community-based cohorts from the Cardiovascular Health Study (CHS) and the Atherosclerosis Risk in Communities study (ARIC). “CHS enrolled patients older than 65 from 1989 to 1994, and we have follow-up data for about 15 years,” explains Dr. Yende. “The ARIC study enrolled patients aged 45 to 65 from 1987 to 1989, and has similar follow-up data.” To determine if the risk of CVD varied over 10 years following hospitalization for pneumonia, the authors identified pneumonia hospitalizations in the CHS and ARIC cohorts. These individuals were then matched with patients without pneumonia and monitored for the development of CVD. Risk was assessed within the 30 days of hospitalization, from 30 to 90 days, from 90 days to 1 year, and then annually thereafter. The researchers also sought to determine if any associations between pneumonia and CVD risk persisted after adjusting for traditional and cardiovascular risk factors. Persistent CVD Risk “Our study confirmed that the risk of CVD events is indeed higher among patients who have had pneumonia when...
Pneumonia & CVD: Making the Link

Pneumonia & CVD: Making the Link

Studies have shown that patients with respiratory tract infections (RTIs) often have higher risk for cardiovascular events than those without RTIs. However, these studies have mostly assessed risk within the first few months after an RTI. Investigations that have assessed long-term risk have had conflicting results. By better characterizing the short- and long-term risks of CVD after an RTI, clinicians may be able to clarify whether these infections are risk factors for CVD and help explain the short- and long-term morbidity and mortality among patients with RTIs. Assessing Risk For a study published in JAMA, Sachin Yende, MD, MS, and colleagues examined community-based cohorts from the Cardiovascular Health Study (CHS) and the Atherosclerosis Risk in Communities study (ARIC). “CHS enrolled patients older than 65 from 1989 to 1994, and we have follow-up data for about 15 years,” explains Dr. Yende. “The ARIC study enrolled patients aged 45 to 65 from 1987 to 1989, and has similar follow-up data.” To determine if the risk of CVD varied over 10 years following hospitalization for pneumonia, the authors identified pneumonia hospitalizations in the CHS and ARIC cohorts. These individuals were then matched with patients without pneumonia and monitored for the development of CVD. Risk was assessed within the 30 days of hospitalization, from 30 to 90 days, from 90 days to 1 year, and then annually thereafter. The researchers also sought to determine if any associations between pneumonia and CVD risk persisted after adjusting for traditional and cardiovascular risk factors. Persistent CVD Risk “Our study confirmed that the risk of CVD events is indeed higher among patients who have had pneumonia when...