Discover and read the best of Twitter Threads about #vancomycin
Most recents (4)
This month marks a decade since I completed medical #internship. I thought then that I had achieved my goal, that I would find joy in my work. Little did I know where life would lead me. My #reminisces & #reflections - too long for a tweet & too short for a blog - hence, a 🧵
As the first & only #medical student in the extended family, I was in #unfamiliar waters. Moving to uncle's house in another city was a not-too-comfortable but not-wholly-unpleasant change. I'm privileged to be part of a family who did all they could to keep me happy
The pedagogy was #authoritative & #oppressive; seemed to be designed to #humiliate, not teach. I couldn't learn by rote, didn't know of any better ways (pre- ubiquitous smartphone era) Expected to address #seniors using honorifics, I felt they were as unapproachable as teachers
Our #vancomycin AUC-based therapeutic drug monitoring (TDM) counterpoint is out!
Thrilled to work on this with @wfwrighID @BradSpellberg & Twitterless Andrew Shorr 😀
Check out 🧵for highlights? 👇 1/n
Thrilled to work on this with @wfwrighID @BradSpellberg & Twitterless Andrew Shorr 😀
Check out 🧵for highlights? 👇 1/n
Brief background.
1st 2009 #vancomycin guidelines recommended troughs 15-20 for serious MRSA infections due to #vancomycin ‘MIC creep’ & associated treatment failures.
But not based on evidence for efficacy or safety 😶
academic.oup.com/ajhp/article-a… 2/n
1st 2009 #vancomycin guidelines recommended troughs 15-20 for serious MRSA infections due to #vancomycin ‘MIC creep’ & associated treatment failures.
But not based on evidence for efficacy or safety 😶
academic.oup.com/ajhp/article-a… 2/n
Since then, we learned MRSA #vancomycin ‘MIC creep’ likely due inherent MIC assay variability / limited clonal outbreaks.
academic.oup.com/jac/article/73… 3/n
academic.oup.com/jac/article/73… 3/n
up bright and early to hear @IDpharmresearch, Dr. Jennifer Le, and Dr. Tom Lodise to go through the new #vancomycin guidelines at #ASHP19 
@IDpharmresearch AUC/MIC is the PK/PD target for all lipoglycopeptides, including newer agents #ASHP19
Round 2 of the Great ID Debates of #ASHP18 @ASHPOfficial comes to us from the brilliant minds of @SIDPharm members @TimbrookTT and @julie_justo. To start us off, Tristan makes the case for #fidaxomicin (FID) for treatment of Clostridioides difficile (#cdiff) infection
.@TimbrookTT sets up the major points for FID in the treatment of #Cdiff: 1- ⬇️recurrence compared to #vancomycin (VAN) in RCTs + ⬆️in cure without recurrence (aka global clinical cure) 2- this held up in real-world data 3- cost-effectiveness analyses support 1st line use #ASHP18
.@TimbrookTT notes the 2018 @IDSAInfo guidelines for #cdiff (idsociety.org/practice-guide…) recommend FID equally to VAN and for first recurrence, quality of evidence is higher 👀🤔#ASHP18
