Gram-negative (GN) bacterial infections present a daunting challenge for clinicians, as they can be especially hard to treat and are associated with high morbidity and mortality, particularly when dealing with carbapenem-resistant Enterobacteriaceae (CRE) and other antibiotic-resistant pathogens. While the development of novel antibiotic classes to overcome resistance has been lacking, recent advances in the development of next-generation agents as of well-established classes has the potential to help address the critical need for effective therapies for serious, drug-resistant GN infections. As such, it is crucial for members of the infectious disease clinical team who treat these patients to understand how these emerging therapies differ from their more conventional predecessors, how they may effectively fit into current treatment paradigms, and how to effectively approach dosing and therapeutic drug management in order to optimize health outcomes for these difficult-to-treat patients.
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Cytomegalovirus (CMV) infection remains a frequent complication in hematopoietic stem cell transplantation (HSCT) and solid organ transplantation (SOT) recipients. In addition to causing a variety of end-organ diseases, CMV infection is also associated with rejection after SOT and with graft versus host disease (GVHD) after HSCT, as well as with increased risk of secondary bacterial and fungal infections. Antiviral prophylaxis, more commonly used after SOT, is effective against direct and indirect effects of CMV infection, but may lead to overtreatment. Preemptive therapy, more commonly used after HSCT, is based on surveillance, and targets therapy to patients at highest risk. Several antiviral agents are currently available for CMV management; however, their use may be associated with myelosuppression and nephrotoxicity. Novel antiviral therapies with different mechanisms of action are in late-stage development and hold the promise of reducing CMV-related morbidity and mortality.
In the United States, as many as 2 million patients are annually diagnosed with antibiotic-resistant Gram-positive or Gram-negative (GP/GN) infections. Unfortunately, the development of novel antibiotics has lagged dangerously behind the emergence of resistant infections, leaving these patients with limited treatment options. Recently, several novel antibiotics have been approved, and more are in the clinical pipeline, many of which have proven to be particularly effective in patients with harder-to-treat GP and/or GN pathogens. However, in the absence of the judicious use of these new antibiotics, acquired resistance to these new agents is inevitable. This archived symposium will provide participants with the opportunity to review the clinical utility of new and investigational antimicrobials while also focusing on strategies to promote careful, appropriate antibiotic utilization. Interactive patient case scenarios will allow clinicians to apply acquired knowledge of antibiotic use to real-world examples of treating patients with GP/GN infections.
This CME/CE-accredited CME Snapshot™ four-part series is intended for infectious disease physicians and other clinicians who manage patients with HIV. During these activities, expert faculty will participate in a series of interactive discussions on the latest evidence and their clinical experience managing patients with HIV.