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Latest & greatest articles for antibiotics
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Antibiotics also referred to as antibacterial are a type of medicine that prevents the growth of bacteria. As such they are used to treat infections caused by bacteria. They kill or prevents bacteria from spreading.
Antibiotics are vital in modern day medicine; they are among the most frequently prescribed drug. There are over a 100 types of antibiotics, the main types and most commonly prescribed are penicillin, cephalosporin, macrolides, fluoroquinolone and tetracycline. They tend to be classified by mechanism of action. So, those that target the bacterial cell wall (penicillins and cephalosporins) or the cell membrane (polymyxins), or interfere with essential bacterial enzymes (rifamycins, lipiarmycins, quinolones, and sulfonamides) have bactericidal activities. Antibiotics such as macrolides, lincosamides and tetracyclines inhibit protein synthesis.
Antibiotics can all be defined by their specificity. “Narrow-spectrum” antibiotics target specific types of bacteria, for instance gram-negative (-ve) or gram-positive (+ve), whereas broad-spectrum antibiotics affect a wide range of bacteria.
Antibiotics are increasingly suffering from antibiotic resistance caused by bacterial mutations meaning the bacteria evolves to not be sensitive to the specific antibiotics being used.
Clinical trials are important to the development and understanding of antibiotics and their side effects. Although they are deemed safe, over use of the drug can kill good bacteria and lead to antibiotic resistance. This halts the ability of bacteria and microorganisms to resist the effects of the antibiotic. Clinical trials and research allow scientists and medical professionals to study the effects and develop new antibiotics.
Interventions to modify antibiotic use in children with suspected infections in peripheral health care settings in LMICs: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content
Attitudes, knowledge and behaviours of the public and patients towards antibiotics and antimicrobial resistance in the UK: a systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content
The impact of interventions aimed at improving antibiotics use in developing countries: a systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files
Antibiotic allergy. Antibiotics are the commonest cause of life-threatening immune-mediated drug reactions that are considered off-target, including anaphylaxis, and organ-specific and severe cutaneous adverse reactions. However, many antibiotic reactions documented as allergies were unknown or not remembered by the patient, cutaneous reactions unrelated to drug hypersensitivity, drug-infection interactions, or drug intolerances. Although such reactions pose negligible risk to patients (...) , they currently represent a global threat to public health. Antibiotic allergy labels result in displacement of first-line therapies for antibiotic prophylaxis and treatment. A penicillin allergy label, in particular, is associated with increased use of broad-spectrum and non-β-lactam antibiotics, which results in increased adverse events and antibiotic resistance. Most patients labelled as allergic to penicillins are not allergic when appropriately stratified for risk, tested, and re-challenged. Given
Shared decision making in primary care can reduce antibiotic prescribing Shared decision making in primary care can reduce antibiotic prescribing Discover Portal Discover Portal Shared decision making in primary care can reduce antibiotic prescribing Published on 26 January 2016 doi: Strategies, known as shared decision making, reduced antibiotic prescribing for people with acute respiratory infections by almost 40% in the short term (up to six weeks). This Cochrane systematic review compared (...) and the other six were from high-income European countries and Canada, so the findings are applicable to the UK. There is insufficient evidence about the long term effect (up to one year and beyond) of the strategies used to facilitate shared decision making, so it is not known whether they could reverse community-level antibiotic resistance trends. It is likely that multiple approaches will be needed. Share your views on the research. Why was this study needed? Antibiotic resistance is now seen
A systematic review of local antibiotic devices used to improve wound healing following the surgical management of foot infections in diabetics Local antibiotics are used in the surgical management of foot infection in diabetic patients. This systematic review analyzes the available evidence of the use of local antibiotic delivery systems as an adjunct to surgery.Databases were searched to identify eligible studies and 13 were identified for inclusion.Overall, the quality of the studies (...) reduction was identified when using an antimicrobial gel to deliver antibiotics and anti-biofilm agents (quorum-sensing inhibitors) compared with routine dressings and systemic antibiotics. Analyses of case series identified 485 patients who were treated using local antibiotic delivery devices. The rates of wound healing, re-operation, and mortality were comparable to those that have been previously reported for the routine management of these infections.There is a lack of good-quality evidence
Triple Antibiotic Solution Promotes Similar Antibacterial Effects as Calcium Hydroxide/2% Chlorhexidine When Used as an Intracanal Medicament UTCAT3361, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Triple Antibiotic Solution Promotes Similar Antibacterial Effects as Calcium Hydroxide/2% Chlorhexidine When Used as an Intracanal Medicament Clinical Question In patients undergoing non-surgical therapy in a tooth (...) diagnosed with pulpal necrosis, does the use of triple antibiotic paste as an intracanal medicament have better antibacterial efficacy than a calcium hydroxide/chlorhexidine formulation? Clinical Bottom Line Triple antibiotic solution (1 mg/mL) promoted similar antibacterial effects as calcium hydroxide/2% chlorhexidine when used as an intracanal medicament. This is based on several randomized clinical trials in which intracanal medicaments were placed for 7 to 21 days in primary and immature/mature
Advances in optimizing the prescription of antibiotics in outpatient settings. The inappropriate use of antibiotics can increase the likelihood of antibiotic resistance and adverse events. In the United States, nearly a third of antibiotic prescriptions in outpatient settings are unnecessary, and the selection of antibiotics and duration of treatment are also often inappropriate. Evidence shows that antibiotic prescribing is influenced by psychosocial factors, including lack of accountability (...) , perceived patient expectations, clinician workload, and habit. A varied and growing body of evidence, including meta-analyses and randomized controlled trials, has evaluated interventions to optimize the use of antibiotics. Interventions informed by behavioral science-such as communication skills training, audit and feedback with peer comparison, public commitment posters, and accountable justification-have been associated with improved antibiotic prescribing. In addition, delayed prescribing, active
A review of antibiotic prophylaxis for travelerâ€™s diarrhea: past to present As there is rapid increase in international travel to tropical and subtropical countries, there will likely be more people exposed to diarrheal pathogens in these moderate to high risk areas and subsequent increased concern for traveler's diarrhea. The disease may appear as a mild clinical syndrome, yet a more debilitating presentation can lead to itinerary changes and hospitalization. As bacterial etiologies (...) are the most common causative agents of TD, the use of antibiotic prophylaxis to prevent TD has been reported among travelers for several years. The most common type of antibiotic used for TD has changed over 50 years, depending on many influencing factors. The use of antibiotic prophylaxis for TD prevention in travelers is still controversial, mainly because of difficulties balancing the risks and benefits. Many factors, such as emerging drug resistance, side effects, cost and risk behavior need
Hospital-based antibiotic use in patients with Mycobacterium avium complex Treatment guidelines exist for pulmonary Mycobacterium avium complex (MAC) infection, although studies suggest poor concordance in clinician practice. Using a national database including hospital encounters of laboratory-confirmed MAC patients, we sought to characterise US treatment practices. We assessed patients in the Premier Healthcare Database from 2009 to 2013 with two or more MAC-positive cultures or one MAC (...) % resistance-associated therapy. Patients were more likely to receive guidelines-based therapy if they had multiple hospital encounters (aRR 1.5), codes for PNTM (aRR 5.7) or tuberculosis (aRR 4.5) or radiological procedures (aRR 10.9); multiple hospital encounters (aRR 0.8) or a tuberculosis code (aRR 0.1) were less likely to be associated with receiving resistance-promoting regimens. In hospital-based MAC patients, half received antibiotics active against MAC, a low proportion received therapy based
The Hidden Cost of Commercial Antibiotic-Loaded Bone Cement: A Systematic Review of Clinical Results and Cost Implications Following Total Knee Arthroplasty The purpose of this systematic review is to compare deep prosthetic joint infections (PJIs) between total knee arthroplasty (TKA) patients treated with either antibiotic-loaded bone cement (ALBC) or plain bone cement, and to explore the potential cost implications of commonly used bone cement regimens. We hypothesized that ALBC would
Systemic Antibiotics for the Treatment of Skin and Soft Tissue Abscesses: A Systematic Review and Meta-Analysis Systemic Antibiotics for the Treatment of Skin and Soft Tissue Abscesses: A Systematic Review and Meta-Analysis Michael Gottlieb, MD*; Joshua M. DeMott, PharmD, MSc; Marilyn Hallock, MD, MS; Gary D. Peksa, PharmD *Corresponding Author. E-mail: firstname.lastname@example.org, Twitter: @MGottliebMD. Study objective: The addition of antibiotics to standard incision and drainage (...) is controversial, with earlier studies demonstrating no signi?cant bene?t. However, 2 large, multicenter trials have recently been published that have challenged the previous literature. The goal of this review was to determine whether systemic antibiotics for abscesses after incision and drainage improve cure rates. Methods: PubMed, the Cumulative Index of Nursing and Allied Health Literature, Scopus, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials
Is Antibiotic Therapy Helpful for Preventing Infection After Acute Stroke? (SRS therapy) Is Antibiotic Therapy Helpful for Preventing Infection After Acute Stroke? TAKE-HOME MESSAGE In patients with acute ischemic or hemorrhagic stroke, prophylactic antibiotics reduce the overall infection rate, but do not reduce the risk of pneumonia, death or dependency. EBEM Commentators Latha Ganti, MD, MBA Department of Clinical Sciences University of Central Florida College of Medicine Orlando, FL Bryan (...) Sleigh, MD Department of Emergency Medicine Mercer University School of Medicine Macon, GA Jestin N. Carlson, MD, MS, and Alan Jones, MD, serve as editors of the SRS series. Editor’s Note: This is a clinical synopsis, a regular feature of the Annals’ Systematic Review Snapshot (SRS) series. The source for this systematic review snapshot is: Vermeij JD, Westendorp WF, Dippel DWJ, et al. Antibiotic therapy for preventing infections in people with acute stroke. Cochrane Database Syst Rev. 2018;1
Inhaled antibiotics for pulmonary exacerbations in cystic fibrosis. Cystic fibrosis is a genetic disorder in which abnormal mucus in the lungs is associated with susceptibility to persistent infection. Pulmonary exacerbations are when symptoms of infection become more severe. Antibiotics are an essential part of treatment for exacerbations and inhaled antibiotics may be used alone or in conjunction with oral antibiotics for milder exacerbations or with intravenous antibiotics for more severe (...) infections. Inhaled antibiotics do not cause the same adverse effects as intravenous antibiotics and may prove an alternative in people with poor access to their veins. This is an update of a previously published review.To determine if treatment of pulmonary exacerbations with inhaled antibiotics in people with cystic fibrosis improves their quality of life, reduces time off school or work and improves their long-term survival.We searched the Cochrane Cystic Fibrosis Group's Cystic Fibrosis Trials
Prophylactic antibiotic therapy for chronic obstructive pulmonary disease (COPD). There has been renewal of interest in the use of prophylactic antibiotics to reduce the frequency of exacerbations and improve quality of life in chronic obstructive pulmonary disease (COPD).To determine whether or not regular (continuous, intermittent or pulsed) treatment of COPD patients with prophylactic antibiotics reduces exacerbations or affects quality of life.We searched the Cochrane Airways Group Trials (...) Register and bibliographies of relevant studies. The latest literature search was performed on 27 July 2018.Randomised controlled trials (RCTs) that compared prophylactic antibiotics with placebo in patients with COPD.We used the standard Cochrane methods. Two independent review authors selected studies for inclusion, extracted data, and assessed risk of bias. We resolved discrepancies by involving a third review author.We included 14 studies involving 3932 participants in this review. We identified
Antibiotics for exacerbations of chronic obstructive pulmonary disease. Many patients with an exacerbation of chronic obstructive pulmonary disease (COPD) are treated with antibiotics. However, the value of antibiotics remains uncertain, as systematic reviews and clinical trials have shown conflicting results.To assess effects of antibiotics on treatment failure as observed between seven days and one month after treatment initiation (primary outcome) for management of acute COPD exacerbations (...) , as well as their effects on other patient-important outcomes (mortality, adverse events, length of hospital stay, time to next exacerbation).We searched the Cochrane Central Register of Controlled Trials (CENTRAL), in the Cochrane Library, MEDLINE, Embase, and other electronically available databases up to 26 September 2018.We sought to find randomised controlled trials (RCTs) including people with acute COPD exacerbations comparing antibiotic therapy and placebo and providing follow-up of at least
Preventive antibiotics for gallbladder surgery not required in those at low or moderate risk Preventive antibiotics for gallbladder surgery not required in those at low or moderate risk Discover Portal Discover Portal Preventive antibiotics for gallbladder surgery not required in those at low or moderate risk Published on 4 December 2015 doi: Guidelines recommend that antibiotics are only prescribed before gallbladder keyhole surgery (laparoscopy) to those at increased risk of infection (...) . However, 36% of surgeons still prescribe them. This systematic review found that antibiotics given before removing the gall bladder by keyhole surgery for gallstone colic did not reduce the rate of surgical site infection, distant site infections or hospital-acquired infections. Though adverse effects due to the antibiotics were uncommon, inappropriate use adds to the growing problem of antimicrobial resistance. The review findings support NICE and the Royal College of Surgeon guidelines. Share your
Decontamination Strategies and Bloodstream Infections With Antibiotic-Resistant Microorganisms in Ventilated Patients: A Randomized Clinical Trial. The effects of chlorhexidine (CHX) mouthwash, selective oropharyngeal decontamination (SOD), and selective digestive tract decontamination (SDD) on patient outcomes in ICUs with moderate to high levels of antibiotic resistance are unknown.To determine associations between CHX 2%, SOD, and SDD and the occurrence of ICU-acquired bloodstream infections (...) with multidrug-resistant gram-negative bacteria (MDRGNB) and 28-day mortality in ICUs with moderate to high levels of antibiotic resistance.Randomized trial conducted from December 1, 2013, to May 31, 2017, in 13 European ICUs where at least 5% of bloodstream infections are caused by extended-spectrum β-lactamase-producing Enterobacteriaceae. Patients with anticipated mechanical ventilation of more than 24 hours were eligible. The final date of follow-up was September 20, 2017.Standard care was daily CHX 2
New evidence available on corticosteroids added to antibiotics in severe pneumonia New evidence available on corticosteroids added to antibiotics in severe pneumonia Discover Portal Discover Portal New evidence available on corticosteroids added to antibiotics in severe pneumonia Published on 9 November 2015 doi: For adults admitted to hospital with severe pneumonia, this review found that adding corticosteroids to the usual antibiotic treatment may be beneficial. The evidence was less (...) costs and loss of life: between 22 and 42% of adults with community acquired pneumonia are admitted to hospital and 5 to 14% of people with more severe illness die from the condition. Antibiotics are the main treatment for pneumonia. A 2011 systematic review of six small trials found that adding corticosteroid treatment increased speed of recovery slightly, but the evidence was not strong. The current review aimed to update the evidence on benefits and potential side effects of add-on corticosteroid
Isolation and genomic characterization of six endophytic bacteria isolated from Saccharum sp (sugarcane): Insights into antibiotic, secondary metabolite and quorum sensing metabolism Six endophytic bacteria were isolated from Saccharum sp (sugarcane) grown in the parish of Westmoreland on the island of Jamaica located in the West Indies. Whole genome sequence and annotation of the six bacteria show that three were from the genus Pseudomonas and the other three were from the genera Pantoea (...) , Pseudocitrobacter, and Enterobacter. A scan of each genome using the antibiotics and secondary metabolite analysis shell (antiSMASH4.0) webserver showed evidence that the bacteria were able to produce a variety of secondary metabolites. In addition, we were able to show that one of the organisms, Enterobacter sp RIT418 produces N-acyl-homoserine lactones (AHLs), which is indicative of cell-cell communication via quorum sensing (QS).