Discover and read the best of Twitter Threads about #LearnwithDrAksh

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What do you use for treatment for endocarditis caused by HLAR +ve Enterococcus faecalis?
🧵 Tomorrow
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Lets talk about #Enterococcus #bacteremia 🧵
2 important species - E.faecalis, E faecium
E.faecium is generally more resistant, but lower risk of endocarditis
E.faecalis, usually S to Ampicillin, but IR to Quinopristin-Dalfopristin
1/6
Also, note- Enterococcus is IR to Cephalosporins, Aminoglycosides
Bacteremia source - Indwelling catheter, GI, Urinary tract
DOC for bacteremia - Ampicillin/Penicillin if S
If, Ampi R - Vanco/Teico
Combination therapy in case of suspicion of endocarditis or septic shock
2/6
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How many of you do Skin test before administration of antibiotics?
Most Indian hospitals test for antibiotic sensitivity, without knowing the basis of testing
Lets learn a lil about Antibiotic allergy testing 🧵
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1/12
1. Skin test - Is done to identify hypersensitivity - which can be IgE or Non IgE mediated. Hence, sensitivity can be seen within 1h (IgE mediated) or >1h (Non-IgE mediated)
So, no guarantee that a patient with skin test negative will not have hypersensitivity later
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