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ON DEMAND: Adaptation in the Management of MRSA: Keeping Up with the Bug, the Drugs and the Healthcare System

Program Description

The substantial mortality associated with methicillin-resistant Staphylococcus aureus (MRSA) infection is all the more worrisome when the history of the pathogen over the last 50 years is examined. Staphylococcus aureus has demonstrated an ability for survival through adaptation, now with reports of the emergence of the multi-resistance gene cfr most recently creating global concern. The cfr gene confers resistance to several antibiotics, including chloramphenicol, clindamycin, and linezolid.

With the emergence of community-associated MRSA and hetero-resistant MRSA, it is important that pharmacists be familiar with all available agents for the management of MRSA infections. It is also essential to choose the appropriate antimicrobial agent for the infection being treated, but this task is not without challenge.

Regulatory authorities have shifted the approach to antibiotic study design that challenges clinicians’ interpretation of results. This at a time when the Affordable Care Act has driven the implementation of Accountable Care Organizations with overall quality and outcomes measures that outweigh a siloed cost mentality as providers assume increased financial risk.

While antibiotic pipelines have begun to fill, actual approval of new products has been limited, with only three late-phase products on the horizon. These three products, however, have the potential to shift treatment paradigms as they make their way into clinical practice.

This activity will explore the next phase of MRSA evolution, the spectrum of available and near-term agents for its treatment, and ways that clinicians can apply an understanding of the corresponding drivers of efficacy, safety, and economics in order to implement evidence-based treatment approaches that best reduce the morbidity and mortality of MRSA infections.


Learning Objectives

After completing this knowledge-based activity, participants should be able to:

  1. Describe the clinical implications of recent changes in methicillin-resistant Staphylococcus aureus (MRSA) as a pathogenic organism and the impact on patient outcomes.
  2. Recognize the benefits, risks, and gaps of currently available therapies for infections due to MRSA.
  3. Recall the current pipeline of evolving products for the management of infections due to MRSA and explain how they may impact the current treatment paradigm by driving improved patient outcomes.
  4. Review the possible impact of the Affordable Healthcare Act and acceleration of the development of Accountable Care Organizations, while exploring best practices to select and prescribe the appropriate product(s) based upon the patient and infection type.


Target Audience
The intended target audience for this activity is health-system pharmacists with an interest in infectious diseases.   

Method of Participation
There are no fees for participating in and receiving credit for this activity. Participants must participate in the session and complete an activity evaluation form.

Accreditation Statement
ACPE LogoMedEDirect is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This activity has been assigned ACPE Universal Activity Number 0498-0000-13-010-H01-P and will award 1.5 contact hours (0.15 CEUs).  Participants that attended the ASHP Live Symposia (Universal Activity Number 0498-0000-13-008-L04-P) and applied for ACPE credit, may not participate in this ON DEMAND activity.



Scientific Integrity and Disclosure of Financial Interests

MedEDirect requires that all CE information be based on the application of research findings and the implementation of evidence-based medicine. MedEDirect promotes balance, objectivity, and absence of bias in its content. All persons in a position to control the content of this activity must disclose any conflict of interest. MedEDirect has mechanisms in place to resolve all conflicts of interest prior to an educational activity being delivered to the learners.

Andrew F. Shorr, MD, MPH is a member of paid speakers bureaus for Astellas Pharma US, Cubist Pharmaceuticals, and Pfizer. He is a consultant to Astellas Pharma US, Bayer, Cubist, Pfizer, and Theravance.

Keith Kaye, MD, MPH is a member of paid speakers bureaus for Cubist Pharmaceuticals, Forest Laboratories, and Pfizer. He has also received research support from and served as a consultant to Cubist, Forest, and Pfizer.

Keith A. Rodvold, PharmD is a member of paid speakers bureaus for Cubist Pharmaceuticals, Durata, Forest Laboratories, and Pfizer. He has received research support from Forest and Theravance. Dr. Rodvold is a consultant to Rempex, and serves on a scientific advisory board for Zavante Therapeutics.

Support Statement   This activity is supported by an unrestricted educational grant from  Cubist Logo




Faculty Biographies


Andrew F. Shorr, MD, MPH
Associate Chief, Pulmonary and Critical Care
Washington Hospital Center
Associate Professor of Medicine
Georgetown University Hospital
Washington, DC


Dr. Shorr received his undergraduate training at Princeton University, in Princeton, New Jersey, and his graduate training in public health at Johns Hopkins University in Baltimore, Maryland. He received his medical degree from the University of Virginia School of Medicine in Charlottesville, and completed his internship and residency in internal medicine at the Walter Reed Army Medical Center in Washington, DC, where he also completed his fellowship in pulmonary and critical care medicine. In addition, Dr. Shorr is board certified in internal medicine, pulmonary medicine, and critical care medicine.

Dr. Shorr has extensive teaching experience. In addition to his professional duties, he is an active member of the World Association of Sarcoidosis and Other Granulomatous Disorders, the American Thoracic Society, the American College of Chest Physicians, and the American College of Physicians. He is a member of both the FDA Commissioner’s Institutional Review Board Committee and the Scientific Advisory Committee of the Sarcoidosis Research Institute.

Dr. Shorr serves on the editorial advisory board of the pulmonary section of Medscape and is a reviewer of the American Board of Internal Medicine pulmonary subspecialty examination. He is a reviewer for various journals, such as Intensive Care Medicine, American Journal of Managed Care, Journal of Bronchoscopy, Journal of the American Medical Association, and Critical Care Medicine. He also serves on the editorial board for the journal Chest.

Dr. Shorr has lectured and written widely, with an emphasis on sarcoidosis, nosocomial infection, and outcomes research. He is a recipient of numerous honors and awards, including the Outstanding Teacher Award from the Walter Reed Army Medical Center, Outstanding Medical Student Teacher Award from the Uniformed Services University, the Washington Area Critical Care Society Basic Science Award, and the American College of Chest Physicians Young Investigator Award.


Keith S. Kaye, MD, MPH
Professor of Medicine, Wayne State University
Corporate Vice President of Quality and Patient Safety
Corporate Medical Director, Infection Prevention,
Epidemiology and Antimicrobial Stewardship, Detroit Medical Center
Detroit, MI

Dr. Kaye received his medical degree from the University of Pennsylvania and served his Internal Medicine residency and was an Infectious Diseases fellow at Beth Israel Deaconess Medical Center in Boston, Massachusetts. During fellowship, he earned a master’s degree in Public Health from the Harvard School of Public Health. Dr. Kaye has authored over 120 peer-reviewed articles and 15 book chapters, including a chapter in hospital epidemiology and infection control, and has presented numerous abstracts at national conferences. Dr. Kaye has been a national leader in infection prevention and antimicrobial stewardship. He currently serves as principal investigator on a multi-center NIH-funded contract studying colistin-based therapy for infections due to extremely drug-resistant (XDR) Gram-negative bacilli.

Dr. Kaye’s particular academic interests and skills are epidemiology of and outcomes associated with multi-drug resistant bacteria; infections in the elderly; surgical site infection; device-related infections; and antimicrobial stewardship. Dr. Kaye oversees all infection prevention and antibiotic stewardship-related activities at Detroit Medical Center, an 8-hospital health system that has over 2000 beds and that includes both community and tertiary care hospitals.


Keith A. Rodvold, PharmD, FCCP, FIDSA
Professor of Pharmacy Practice and Pharmacy in Medicine
Colleges of Pharmacy and Medicine
Co-Director, Section of Infectious Diseases Pharmacotherapy
Department of Pharmacy Practice
University of Illinois at Chicago
Chicago, IL

Dr. Keith A. Rodvold received his BS and PharmD degrees from the University of Minnesota. He completed his research fellowship in clinical pharmacokinetics and pharmacology at St. Paul-Ramsey Medical Center and the University of Minnesota, and was a Clinical Pharmacy Specialist at St. Joseph’s Hospital in Marshfield, Wisconsin, from 1981 to 1984. Dr. Rodvold was appointed as an Assistant Professor in the Department of Pharmacy Practice at the University of Illinois at Chicago in 1984, promoted to the rank of Associate Professor with tenure in 1989, and to the rank of Professor in 1994. He is also a Professor of Pharmacy Practice and Pharmacy in Medicine in the Colleges of Pharmacy and Medicine at the University of Illinois at Chicago.

Dr. Rodvold is currently conducting research in the area of clinical pharmacokinetics and pharmacodynamics of anti-infective and chemoprevention agents, funded by the NCI/NIH and major pharmaceutical companies. He has authored more than 125 original research and review publications, 40 book chapters, and served as co-editor of the textbook Drug Interactions in Infectious Diseases. The American College of Clinical Pharmacy presented Dr. Rodvold with the 2003 Russell R. Miller Award in recognition of his sustained and outstanding contributions to the literature of clinical pharmacy. He is a former member of the Anti-Infective Drug Advisory Committee and Pediatric Drug Advisory Subcommittee for the Food and Drug Administration, and an active member of numerous professional societies and has been elected Fellow of the Infectious Diseases Society of America, American College of Clinical Pharmacology, and American College of Clinical Pharmacy.

References and Resources


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