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grepmeded's profile
GrepMed
GrepMed
GrepMed
@grepmeded

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GrepMed

@grepmeded

Image Based Medical Reference: Sharing crowd-sourced checklists, algorithms, decision aids, #PhysicalExam #POCUS, and more - by @GeraldMDMD + @k00bideh

Sacramento, CA
grepmed.com
Joined March 2018

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    1. Varun Phadke MD‏ @VarunPhadke2 12 Oct 2019
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      3/ Let’s start with a horizontal bar that represents the spectrum of clinically important bacteria. We will represent antibiotics above that spectrum with another horizontal bar.pic.twitter.com/buHJzCxLIW

      1 reply 3 retweets 13 likes
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    2. Varun Phadke MD‏ @VarunPhadke2 12 Oct 2019
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      4/ If you shined a light from above the antibiotic, it would cast a shadow on that part of the spectrum – you might say it ‘covers’ that part of the spectrum.pic.twitter.com/FwmTGspDZu

      1 reply 3 retweets 6 likes
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    3. Varun Phadke MD‏ @VarunPhadke2 12 Oct 2019
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      5/ Narrow spectrum antibiotics cover only a sliver of the spectrum.pic.twitter.com/Dkdiuya1nN

      1 reply 3 retweets 7 likes
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    4. Varun Phadke MD‏ @VarunPhadke2 12 Oct 2019
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      6/ We ‘expand’ or ‘broaden’ this coverage by selecting a ‘broad spectrum’ antibiotic. I’ve drawn the broad spectrum abx above the narrow spectrum abx to illustrate the concept of “escalation” and “de-escalation”.pic.twitter.com/V5wLyagw7u

      1 reply 3 retweets 5 likes
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    5. Varun Phadke MD‏ @VarunPhadke2 12 Oct 2019
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      7/ Let’s add names to the spectrum. On the left is Gram pos (because we always name Gram pos abx 1st, right? @PaulSaxMD) and on the right is Gram neg. I’ve also dropped 2 vertical lines – Abx A covers ONLY Gram pos, Abx C covers ONLY Gram neg, and Abx B covers a bit of both.pic.twitter.com/DOqNqaZnYj

      1 reply 3 retweets 14 likes
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    6. Varun Phadke MD‏ @VarunPhadke2 12 Oct 2019
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      8/ Ideally, we could arrange all the clinically important organisms in a way that allowed us to depict every abx as a continuous horizontal bar – alas, this is not possible, and thus most abx have “holes” in their coverage!pic.twitter.com/sp3DnidgOk

      1 reply 2 retweets 10 likes
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    7. Varun Phadke MD‏ @VarunPhadke2 12 Oct 2019
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      9/ Let’s take it a step further and put actual organism names on the spectrum – this lets us compare/contrast important drug classes with granularity. For example, here’s the Gram pos part of the spectrum filled in with the penicillins and cephalosporins.pic.twitter.com/WUOjiuCorD

      1 reply 2 retweets 15 likes
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    8. Varun Phadke MD‏ @VarunPhadke2 12 Oct 2019
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      10/ Here’s the Gram neg end of the spectrum comparing some common beta lactam drugs.pic.twitter.com/XAOkjsQsBd

      1 reply 2 retweets 13 likes
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    9. Varun Phadke MD‏ @VarunPhadke2 12 Oct 2019
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      11/ We can combine these two ends into 1 continuous spectrum. I also add anaerobes as the bridge between the two, and place intracellular organisms (like Legionella and Mycoplasma) on one end. In the next tweet will be the composite figure with all the commonly encountered abx!pic.twitter.com/ZcYFdZl8De

      1 reply 2 retweets 14 likes
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    10. Varun Phadke MD‏ @VarunPhadke2 12 Oct 2019
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      12/ In this final figure, abx are divided by beta lactam and non beta lactam. Since we know that in vitro activity does not equal clinical use, I’ve color coded the abx bars – green means active and preferred, dark blue means active, and light blue means unreliably active.pic.twitter.com/jykLIrvHh2

      15 replies 91 retweets 285 likes
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      GrepMed‏ @grepmeded 19 Nov 2019
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      Replying to @VarunPhadke2

      Great image! Hope you don't mind we shared this to make it easy for others to search and bookmark. "antibiogram" ->https://www.grepmed.com/images/6388 

      4:57 PM - 19 Nov 2019
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