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I disagree with you, Alastair. I believe @PanData19 is filling in the gaps that governments have failed to fill. I encourage you to have an open mind and listen intently to what we have to say. 1/n


Here’s how @PanData19 is approaching this crisis differently from governments:
We believe that "health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."- @WHO 2/n

To tackle the problem holistically, we have formed a multidisciplinary team made up of immunologist, microbiologist, geneticists, data scientists, physicians, economist, psychologists, educators, public health professionals and business owners. 3/n

We have also backed ourselves with a scientific advisory board made up of prominent experts in their fields.
@MartinKulldorff
@SunetraGupta
@MLevitt_NP2013
@MichaelYeadon3
#JayBhattacharya
#SucharitBhakdi
They are supporting us every step of the way. 4/n

We believe that "the right to health is one of a set of internationally agreed human rights standards, and is inseparable or ā€˜indivisible’ from these other rights.ā€ @WHO 5/n
1/15
Why can cefepime cause neurological toxicity?

And why is renal failure the main risk factor for this complication?

The answer requires us to learn about cefepime's structure and why it unexpectedly binds to a certain CNS receptor.

#MedTwitter #Tweetorial


2/
Let's establish a few facts about cefepime:

šŸ”ŗ4th generation cephalosporin antibiotic
šŸ”ŗExcretion = exclusively in the urine (mostly as unchanged drug)
šŸ”ŗReadily crosses the blood-brain barrier (so it easily accesses the brain)

https://t.co/rjYG1BfGPR


3/
The first report of cefepime neurotoxicity was in 1999.

A patient w/ renal failure received high doses of cefepime and then developed encephalopathy, tremors, myoclonic jerks, and tonic-clonic seizures.

āœ…All symptoms resolved after hemodialysis.

https://t.co/u7JLVitQpp


4/
Cefepime neurotoxicity is surprisingly common, occurring in up to 15% of treated critically ill patients (w/ symptoms varying from encephalopathy to seizures).

šŸ’”The main risk factors = renal failure and lack of dose adjustment for renal function.

https://t.co/nxbnzSq8AR


5/
What about cefepime induces neurotoxicity?

One clue is that it's not the only antibiotic that causes neurotoxicity, particularly seizures.

This actually is a class effect w/ other beta-lactam antibiotics (including penicillins and carbapenems).

https://t.co/Lf4BhON9IY