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Volume 18, Number 9—September 2012

CME ACTIVITY - Policy Review

Control of Fluoroquinolone Resistance through Successful Regulation, Australia

Earning CME Credit

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Article Title: Control of Fluoroquinolone Resistance through Successful Regulation, Australia

CME Questions

1. You are a public health official advising a health management organization regarding use of fluoroquinolones. Based on the review by Dr. Cheng and colleagues, which of the following statements about restrictions in Australia regarding use of fluoroquinolones is most likely correct?

A. Quinolones are permitted in steer but not in cows

B. Ciprofloxacin is listed as an option in lower urinary tract infection only in patients with high fever

C. Moxifloxacin is listed as an option for empiric management of most cases of outpatient community-acquired pneumonia

D. Australia’s subsidized outpatient pharmaceutical scheme limits usage of relatively expensive drugs unless prescribed by doctors for indications listed in the Pharmaceutical Benefits Scheme

2. Based on the review by Dr. Cheng and colleagues, which of the following statements about development of fluoroquinolone resistance in Australia compared to that in other countries is most likely correct?

A. In Echerichia coli, quinolone resistance rates in disease-causing isolates have plateaued at a moderate level in Australia

B. Quinolone resistance in locally acquired Campylobacter spp. is about the same in Australia as in most other countries

C. An increase in quinolone resistance in pneumococci in North America was noted following the introduction of levofloxacin into respiratory infection guidelines and widespread usage

D. Quinolone resistance in isolates of Campylobacter spp., Salmonella spp., and E. coli from a variety of food-producing animals and products is not uncommon in Australia due to importation of meat

3. Based on the review by Dr. Cheng and colleagues, which of the following statements about potential harms of restricting fluoroquinolone use, and strategies to eliminate those harms, would most likely be correct?

A. Quinolones can no longer be prescribed at all in Australia

B. Most recommended empirical regimens use quinolones, and appropriate empirical therapy would therefore be delayed

C. No strategies are currently available for quinolone therapy in severely ill, hospitalized patients

D. Quinolones can still be prescribed in Australia when they are necessary or the indicated preferred treatment

Activity Evaluation

1. The activity supported the learning objectives.

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2. The material was organized clearly for learning to occur.

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3. The content learned from this activity will impact my practice.

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4. The activity was presented objectively and free of commercial bias.

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