OVERVIEW
This free activity, entitled “Preventing Fungal Infections in HSCT Recipients: Insights From Clinical Cases,” consists of three presentations and panel discussions, a Learning Assessment, and an Evaluation form.

MEDIA: Virtual Lecture and Podcast
INTERNET RELEASE DATE: October 8, 2009
(Continuing education credit is no longer available for this activity.)

Estimated time to complete this activity: 1.75 hours

TARGET AUDIENCE
This activity has been designed to meet the educational needs of physicians, pharmacists, and registered nurses involved in the care of patients undergoing hematopoietic stem cell transplant (HSCT) who are at risk for fungal infections.

STATEMENT OF NEED
Systemic fungal infections are associated with significant mortality, and some infections appear to be occurring with increasing frequency.1 Hematopoietic stem cell transplant (HSCT) recipients are at increased risk for fungal infection, primarily because of their immunocompromised state resulting from chemotherapy or radiation therapy.2 Candida species and Aspergillus species are the most common causes of fungal infection in HSCT patients and are associated with significant mortality.2-4

Antifungal therapies for the prevention and treatment of fungal infections include polyenes, azoles, echinocandins, and allylamines.1-4 However, despite the availability of a large array of antifungal agents, these infections continue to represent a significant risk to HSCT recipients. Clearly, there are multiple barriers that stand between HSCT recipients and effective therapy for the prevention and treatment of fungal infections.

¹Chandrasekar P. Biol Blood Marrow Transplant. 2005;11:77-84.
²Dykewicz CA, et al. MMWR Morbid Mortal Weekly Rep. 2000; 49(RR10):1-128.
³Wald A, et al. J Infect Dis. 1997;175:1459-1466.
⁴Pagano L, et al. Eur J Haematol. 1999;63:77-85.

EDUCATIONAL OBJECTIVES
After completing this activity, the participant should be better able to:

• Explain the changing epidemiology of invasive fungal infections (IFIs) in hematopoietic stem cell transplant (HSCT) patients
• Use knowledge of variable susceptibility patterns in fungal species to improve patient outcomes
• Recognize patient and environmental factors that impact the individualization of antifungal therapy
• Apply evidence-based strategies for the prevention of IFIs in HSCT patients

METHOD OF PARTICIPATION
There are no fees for participating and receiving continuing education (CE) credit for this activity. During the period October 8, 2009, through October 8, 2010, participants must 1) read the learning objectives and faculty disclosures; 2) study the educational activity; 3) complete the Learning Assessment by recording the best answer to each question in the "Learning Assessment Answers" box on the Evaluation form; 4) complete the Evaluation form; and 5) mail or fax the Evaluation form with the Learning Assessment answers to Postgraduate Institute for Medicine. You may also complete the Learning Assessment online at www.cmeuniversity.com. Click on "Find Post-Test/Evaluation by Course" on the navigation menu, and search by Project ID 6530.

Participants must receive a score of at least 70% on the Learning Assessment and must complete and submit the Evaluation form to successfully complete this activity. Participants who successfully complete the Learning Assessment and Evaluation form via www.cmeuniversity.com will have a statement of credit made available immediately. Participants who successfully complete this activity and submit the Learning Assessment and Evaluation form via fax or mail will be issued a statement of credit via US mail in 4 to 6 weeks.

PHYSICIAN CONTINUING EDUCATION
ACCREDITATION STATEMENT
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 Postgraduate Institute for Medicine (PIM) and Robert Michael Educational Institute LLC (RMEI). PIM is accredited by the ACCME to provide continuing medical education for physicians.

CREDIT DESIGNATION
PIM designates this educational activity for a maximum of 1.75 AMA PRA Category I Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

PHARMACIST CONTINUING EDUCATION
ACCREDITATION STATEMENT
Postgraduate Institute for Medicine (PIM) is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.


CREDIT DESIGNATION
PIM designates this continuing education activity for 1.8 contact hours (0.18 CEUs) of the Accreditation Council for Pharmacy Education. (Universal Activity Number – 0809-9999-09-127-H01-P)

A statement of credit will be issued only upon receipt of a completed activity Evaluation form and will be mailed to you within 3 weeks.

ACTIVITY TYPE: Knowledge

NURSING CONTINUING EDUCATION
CREDIT STATEMENT
This educational activity for 1.8 contact hours is provided by Postgraduate Institute for Medicine (PIM).

ACCREDITATION STATEMENT
PIM is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

CALIFORNIA BOARD OF REGISTERED NURSING
PIM is approved by the California Board of Registered Nursing, Provider Number 13485 for 1.8 contact hours.

FACULTY
Kieren A. Marr, MD
Professor of Medicine
Director, Transplant Medicine and Oncology Infectious Diseases Program
Johns Hopkins University School of Medicine
Baltimore, Maryland

Pranatharthi H. Chandrasekar, MD
Professor of Medicine
Wayne State University School of Medicine
Karmanos Cancer Institute
Chief, Section of Infectious Diseases
Detroit, Michigan

Dimitrios P. Kontoyiannis, MD, ScD, FACP, FIDSA
Professor of Medicine
Deputy Chairman
Director, Mycology Research Program
Department of Infectious Disease and Infection Control
The University of Texas MD Anderson Cancer Center
Houston, Texas

DISCLOSURE OF CONFLICTS OF INTEREST
Postgraduate Institute for Medicine (PIM) assesses conflict of interest with its instructors, planners, managers, and other individuals who are in a position to control the content of continuing education (CE) activities. All relevant conflicts of interest that are identified are thoroughly vetted by PIM for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. PIM is committed to providing its learners with high-quality CE activities and related slides that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CE activity:

• Dr. Kieren A. Marr has affiliations with Astellas Pharma Inc.; Basilea Pharmaceutica Ltd.; Merck & Co., Inc.; Pfizer Inc.; Schering-Plough Corporation (Consultant); and Enzon Pharmaceuticals, Inc. and Merck & Co., Inc. (Research).
• Dr. Pranatharthi H. Chandrasekar has affiliations with Schering-Plough Corporation (Consultant, Speaker’s Bureau) and Pfizer Inc. (Speaker’s Bureau, Research).
• Dr. Dimitrios P. Kontoyiannis has affiliations with Merck & Co., Inc. and Schering-Plough Corporation (Consultant & Advisory Board); Merck & Co., Inc.; Pfizer Inc.; Fujisawa/Astellas Pharma Inc.; and Enzon Pharmaceuticals, Inc. (Speaker’s Bureau); Merck & Co., Inc.; Enzon Pharmaceuticals, Inc., and Jujisawa/Astellas Pharma Inc. (Grant Recipient, Research Support, Speaker Honorarium); and Merck & Co., Inc. (Investigator).

The following planners and managers have the following to disclose:

Robert Michael Educational Institute LLC

• Sherri Kramer, MD, has no affiliations with commercial interests to disclose.
• Laura Altobelli, MS, has no affiliations with commercial interests to disclose.
• Lillian Simmons has no affiliations with commercial interests to disclose.

Postgraduate Institute for Medicine

• Jan Hixon, RN, BSN, MA, has no affiliations with commercial interests to disclose.
• Linda Graham, RN, BSN, has no affiliations with commercial interests to disclose.
• Trace Hutchison, PharmD, has no affiliations with commercial interests to disclose.
• Julia Kirkwood, RN, BSN, has no affiliations with commercial interests to disclose.
• Jan Schultz, RN, MSN, CCMEP, has no affiliations with commercial interests to disclose.

DISCLOSURE OF UNLABELED USE
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Postgraduate Institute for Medicine (PIM), Robert Michael Educational Institute LLC (RMEI) and Schering-Plough do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of PIM, RMEI, or Schering-Plough. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings.

DISCLAIMER
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient's conditions and possible contraindications on dangers in use, review of any applicable manufacturer's product information and comparison with recommendations of other authorities.

FEE INFORMATION
There is no fee for this educational activity.

QUESTIONS & TECHNICAL ASSISTANCE
For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity: jjones@pimed.com. For technical assistance, contact jungsen@rmcom.net.

SYSTEM REQUIREMENTS
Hardware/Software requirements include:
• Windows 95, 98se, ME, XP, NT 4.0, 2000   
  - Internet Explorer 4.0+
  - Netscape Navigator 6.2+
  - AOL 8
  - Mozilla Firefox 1.0+
• Macintosh 9.2, OS X 10.1+
  - Safari 1.1+
  - Netscape Navigator 6.2+
  - Internet Explorer 5.2+
  - Mozilla Firefox 1.0+
• Additional Requirements
  - Macromedia Flash Player 7
  - Internal/external speakers
  - Broadband connection (DSL/cable) recommended

Additional educational activities offered by Robert Michael Educational Institute LLC can be found at www.RMEI.com or by calling toll-free to 866-770-RMEI.

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