⚖️As doctors we guide our practice by the principle: primum, non nocere
⁉️ Premise: pt on hemodialysis develops pneumonia. What antibiotic would you use?
Welcome to #TenTweetNephJC
✳️ 10 tweets #NephJC catch-up ✳️
⁉️ Premise: pt on hemodialysis develops pneumonia. What antibiotic would you use?
Welcome to #TenTweetNephJC
✳️ 10 tweets #NephJC catch-up ✳️
2. What did I miss?
20x⬆️ sudden cardiac death (SCD) in hemodialysis
💊Levofloxacin & Azithromycin - ⬆️QT-interval -> ⬆️ risk of CV outcomes
⁉️ What’s the SCD risk in HD population with these 2 atbx?
pubmed.ncbi.nlm.nih.gov
20x⬆️ sudden cardiac death (SCD) in hemodialysis
💊Levofloxacin & Azithromycin - ⬆️QT-interval -> ⬆️ risk of CV outcomes
⁉️ What’s the SCD risk in HD population with these 2 atbx?
pubmed.ncbi.nlm.nih.gov
3. 1 tweet methods
✅ 2 retrospective cohort studies (Hemodialysis USRD)
✅ Outcome: 5 day sudden cardiac death
✅ Comparator: Azithromycin vs Amoxicillin/Amoxi-based, Azithromycin vs Levofloxacin
✅ 2 retrospective cohort studies (Hemodialysis USRD)
✅ Outcome: 5 day sudden cardiac death
✅ Comparator: Azithromycin vs Amoxicillin/Amoxi-based, Azithromycin vs Levofloxacin
4. 1 tweet results
💔AZI higher risk of SCD vs AMOXI
Number needed to harm with AZI versus AMOXI-based antibiotic: 1in 4000 treatment episodes
💔AZI lower risk of SCD vs LEVO days 6-10
Number needed to harm with LEVO versus AZI: 1 in 5291
💔AZI higher risk of SCD vs AMOXI
Number needed to harm with AZI versus AMOXI-based antibiotic: 1in 4000 treatment episodes
💔AZI lower risk of SCD vs LEVO days 6-10
Number needed to harm with LEVO versus AZI: 1 in 5291
5. 🎨A figure paints 1000 words
6. Give me something clever to say
💡@hswapnil talking about using hip fracture as a negative control outcome in this study
💡@hswapnil talking about using hip fracture as a negative control outcome in this study
7. Chat consensus?
📌Evaluate for CV comorbidities & measure QT interval before deciding which antibiotic to choose
📌Check for other possible QT-prolonging meds (PMID: 20185054) 👇
⚖️Balance the indication with potential risk
📌Evaluate for CV comorbidities & measure QT interval before deciding which antibiotic to choose
📌Check for other possible QT-prolonging meds (PMID: 20185054) 👇
⚖️Balance the indication with potential risk
8. Quote of the fortnight! - from @kidney_boy, #NephJC cofounder.
This really gets to the core of practicing medicine.
This really gets to the core of practicing medicine.
9. I want more info
✅ Follow @rachhung & @anandthedoc
✅ summary from @rachhung & @anandthedoc
nephjc.com
✅ VA by @kidneyrachael
✅ Follow @rachhung & @anandthedoc
✅ summary from @rachhung & @anandthedoc
nephjc.com
✅ VA by @kidneyrachael
10. Final thoughts
✳️ Be curious! Doubt and judge the facts we know! 👇
➡️ Up next -💔 Myth-busting salt restriction in heart failure? See you on July 26 & 27-> SODIUM-HF trial. All internal medicine is invited #CardioTwitter #NephTwitter
thelancet.com
✳️ Be curious! Doubt and judge the facts we know! 👇
➡️ Up next -💔 Myth-busting salt restriction in heart failure? See you on July 26 & 27-> SODIUM-HF trial. All internal medicine is invited #CardioTwitter #NephTwitter
thelancet.com
Tweetorial from Cristina Popa @NephroSeeker, under the guidance of a great mentor (who doesn't want to be mentioned). #NephJC @NSMCInternship
📅 Remember the dates for #NephJC summer book club: Aug 23 and 24
Until then, enjoy different perspectives of this book, find inspiration or intrigue in the real-life story #MedTwitter
Until then, enjoy different perspectives of this book, find inspiration or intrigue in the real-life story #MedTwitter
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