Interprofessional Hem/Onc Morbidity, Mortality, and Improvement Conference - The Pitfalls of Pneumocystis Carinii Pneumonia Prophylaxis



Date & Location
Monday, December 18, 2023, 7:00 AM - Friday, December 18, 2026, 8:00 AM

Credits
AMA PRA Category 1 Credits™ (0.75 hours), ANCC Nursing Contact Hours (0.75 hours), CME-Designated Participation Credit (0.75 hours)

Overview

This MMI session will be presented by Shahab Haghollahi, MD. He will be discussing the “pitfalls of Pneumocystis carinii pneumonia prophylaxis”. 

Presenter
Shahab Haghollahi, MD
Dartmouth Hitchcock Medical Center, Lebanon, NH, GME Office 

Disclosure
The following planning committee member(s), speaker(s), author(s) or anyone in a position to control the content for this activity have reported the following financial relationship (s)* with ineligible company(ies)**. All of the relevant financial relationships listed for these individuals have been mitigated.

Frederick Lansigan – Bristol Myers Squibb/Celgene – Consultant/Advisor  

Other planning committee member(s), speaker(s), activity director(s), author(s) or anyone in a position to control the content for this activity report NO financial relationship(s)* with any ineligible company(ies)**.

* A “financial relationship" includes employee, researcher (named as the PI), consultant, advisor, speaker, independent contractor (including contracted research), royalties or patent beneficiary, executive role, and/or an ownership interest (not including stocks owned in a managed portfolio).

** An ineligible company is any entity whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.


Learning Objectives
At the conclusion of this activity, learners will be able to:

  1. Identify potential barriers to both inpatient and outpatient administration of pneumocystis prophylaxis.

Accreditation

In support of improving patient care, Dartmouth Health is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

American Medical Association (AMA)
Dartmouth Health designates this Enduring Material for a maximum of 0.75 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

American Nurses Credentialing Center (ANCC)
Dartmouth Health designates this Enduring Material for a maximum of 0.75 ANCC contact hours. 

All other learners may claim CME-designated participation credit. Consult your professional licensing board regarding the applicability and acceptance of CME-designated participation credit for programs certified for credit by organizations accredited by Joint Accreditation for Interprofessional Education.

Registration/Requirements for Successful Completion
You may claim credit for successful completion of this online course. In order to claim credit, you must follow these steps:

  1. Click the Register tab above. If you are not logged into your account, you will need to log in. Use the Forgot Your Password? button if you need to reset your password.
  2. Register for the activity.
  3. Click the Content/Tests tab and then View Content to view the recording. View the entire presentation.
  4. Complete the Post-Test (attestation - return to the Content/Tests tab to find it).
  5. Click the Complete Evaluation button, or click My Account in the menu bar; then click Evaluations.
  6. Complete and Submit the Evaluation.

Bibliographic Sources

  • Truong J, Ashurst JV. Pneumocystis jirovecii pneumonia. In: StatPearls. StatPearls Publishing; 2023.

  • Williams KM, Ahn KW, Chen M, et al. The incidence, mortality and timing of Pneumocystis jiroveci pneumonia after hematopoietic cell transplantation: a CIBMTR® analysis. Bone Marrow Transplant. 2016;51(4):573-580.

  • National Comprehensive Cancer Network. Prevention and Treatment of Cancer-Related Infections (Version 3.2022). http://https://www.nccn.org/professionals/physician_gls/pdf/infections.pdf. Accessed April 2, 2023.

  • Souza JP, Boeckh M, Gooley TA, et al. High rates of Pneumocystis carinii pneumonia in allogeneic blood and marrow transplant recipients receiving dapsone prophylaxis. Clin Infect Dis 1999;29:1467-1471.

  • Vasconcelles MJ, Bernardo MV, King C, et al. Aerosolized pentamidine as pneumocystis prophylaxis after bone marrow transplantation is inferior to other regimens and is associated with decreased survival and an increased risk of other infections. Biol Blood Marrow Transplant 2000;6:35-43.

  • Marras TK, Sanders K, Lipton JH, et al. Aerosolized pentamidine prophylaxis for Pneumocystis carinii pneumonia after allogeneic marrow transplantation. Transpl Infect Dis 2002;4:66-74.

  • Sangiolo D, Storer B, Nash R, et al. Toxicity and efficacy of daily dapsone as Pneumocystis jiroveci prophylaxis after hematopoietic stem cell transplantation: a case-control study. Biol Blood Marrow Transplant 2005;11:521-529.

  • DeMasi JM, Cox JA, Leonard D, et al. Intravenous pentamidine is safe and effective as primary pneumocystis pneumonia prophylaxis in children and adolescents undergoing hematopoietic stem cell transplantation. Pediatr Infect Dis J 2013;32:933-936.

  • Diri R, Anwer F, Yeager A, et al. Retrospective review of intravenous pentamidine for Pneumocystis pneumonia prophylaxis in allogeneic hematopoietic stem cell transplantation. Transpl Infect Dis 2016;18:63-69

  • Kim SY, Dabb AA, Glenn DJ, et al. Intravenous pentamidine is effective as second line Pneumocystis pneumonia prophylaxis in pediatric oncology patients. Pediatr Blood Cancer 2008;50:779-783.

  • Stern A, Green H, Paul M, Vidal L, Leibovici L. Prophylaxis for Pneumocystis pneumonia (Pcp) in non?HIV immunocompromised patients. Cochrane Database of Systematic Reviews. 2014;(10).

  • Keisu M, Wiholm BE, Palmblad J. Trimethoprim-sulphamethoxazole-associated blood dyscrasias. Ten years’ experience of the Swedish spontaneous reporting system. J Intern Med. 1990;228(4):353-360.

  • Bozzette SA, Forthal D, Sattler FR, et al. The tolerance for zidovudine plus thrice weekly or daily trimethoprim-sulfamethoxazole with and without leucovorin for primary prophylaxis in advanced HIV disease. California Collaborative Treatment Group. Am J Med. 1995;98(2):177-182.

  • Safrin S, Lee BL, Sande MA. Adjunctive folinic acid with trimethoprim-sulfamethoxazole for Pneumocystis carinii pneumonia in AIDS patients is associated with an increased risk of therapeutic failure and death. J Infect Dis. 1994;170(4):912-917.

  • Parajuli P, Ibrahim AM, Siddiqui HH, Lara Garcia OE, Regmi MR. Trimethoprim-sulfamethoxazole induced pancytopenia: a common occurrence but a rare diagnosis. Cureus. 2019;11(7):e5071

  • Parajuli P, Ibrahim AM, Siddiqui HH, Lara Garcia OE, Regmi MR. Trimethoprim-sulfamethoxazole induced pancytopenia: a common occurrence but a rare diagnosis. Cureus. 2019;11(7):e5071.

Provider Contact Information
Provider contact information for questions regarding accreditation of the activity:

Center for Learning and Professional Development
CE Office
Dartmouth Health
[email protected]