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Akshatha R, MD,DNB,MNAMS,(DM ID)

@LearnwithDrAksh

Jun 8 • 6 tweets • 6 min read Twitter logo

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@CidsIndia

#IDSA AMR Updates 2023
#IDtwitter
#Medtwitter
Updates in ESBL E
To avoid piptaz in non UTI
To avoid Cefepime
No role of Cephamycins
No role of Ceftalazone - Tazobactam
@CidsIndia
@idcon2022 @id_cure
@IDstewardship

Updates in AmpC
Explained well about How to choose Antibiotics in AmpC -

Updates in CRE -
Explicitly mentions TOC for NDM, OXA, KPC & while awaiting reports.
No role of Tetracycline derivatives in UTI/ BSI

Updates in Pseudo
TOC for MDR Pseudo
TOC for MBL - No added benefit of Ceftazidime -avibactam+Aztreonam vs Aztreonam alone
Combination therapy in DTR Pseudo-Don't use Polymxin+Aminoglycosides -use Newer BL-BLI+Tobramycin if tobra is S, if R use Newer BL-BLI+ Polymyxin

Updates in CRAB
CRAB therapy -Sulbactam + Mino>Tige , or Sulbactam + Polymyxin B, Mero + Poly B not to be used
If using Ampicillin - Sulbactam - panel suggest *against* the use of Meropenem in the combination

Stenotrophomonas updates
Combination only - no role of single agent
Ceftazidime -avibactam + Aztreonam if clinical instability, intolerance

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More from @LearnwithDrAksh

Akshatha R, MD,DNB,MNAMS,(DM ID)

@LearnwithDrAksh

Nov 28, 2022

#IDtwitter
#MedTwitter
#MedEd
#Tweetorial
#LearnwithDrAksh
What do you use for treatment for endocarditis caused by HLAR +ve Enterococcus faecalis?
🧵 Tomorrow

#Tweetorial
#IDTwitter
#MedTwitter
#MedEd
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

Read 8 tweets

Akshatha R, MD,DNB,MNAMS,(DM ID)

@LearnwithDrAksh

Nov 27, 2022

#IDtwitter
#MedEd
#MedTwitter
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 🧵
#MedTwitter
#IDtwitter
#MedEd
#tweetorial
#TweetOfTheDay
#LearnwithDrAksh
#
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

Read 14 tweets

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