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
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Image Based Medical Reference: Sharing crowd-sourced checklists, algorithms, decision aids, #PhysicalExam #POCUS, and more - by @GeraldMDMD + @k00bideh
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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
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
10/ Here’s the Gram neg end of the spectrum comparing some common beta lactam drugs.pic.twitter.com/XAOkjsQsBd
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
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
13/
Thoughts #IDTwitter? How do you teach abx/spectra of activity to your learners? What other visuals have you seen? How can we make this better?
@CarlosdelRio7 @BonuraErin @BSchwartzinSF @Armstrws @BradSpellberg @Payal_Patel @PCH_SF @serotavirus @MDdreamchaser @gradydoctor
This is great, and also way more than what I teach students & residents on rounds. I describe four categories: gram-positive (within which we think about MRSA), gram-negatives (within which we think about P.aeruginosa), anaerobes, and “atypical things treated with doxycycline”
We can layer on complexity like activity vs enterococci, ESBL & CRE, etc later, but what I’m more interested in is then going over the human microbiome and then making the connections re: *why* we use the combinations of antibiotics we use for infections @ different sites.
I take a similar approach for med students and housestaff starting with broad categories (GP, GN, anaerobes, etc) then add details during didactic lectures. Not specific enough for an ID nerd (such as myself
), but a framework to get started. Also, I like pretty colors.pic.twitter.com/ldexflGAJx
Ok, revised to include the at least partial gram positive activity of mero-vabor, imi-rele, ceftaz-avi, cefto-tazo (partial owing to the absent enterococcus and unreliable staph of the ceftaz-avi and cefto-tazo). Thanks @dan_uslan for the feedback!pic.twitter.com/28UIww0BW7
Terrific reference image.
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"antibiogram" ->https://www.grepmed.com/images/6389
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