Latest & greatest articles for antibiotics

The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on antibiotics or other clinical topics then use Trip today.

This page lists the very latest high quality evidence on antibiotics and also the most popular articles. Popularity measured by the number of times the articles have been clicked on by fellow users in the last twelve months.

What is Trip?

Trip is a clinical search engine designed to allow users to quickly and easily find and use high-quality research evidence to support their practice and/or care.

Trip has been online since 1997 and in that time has developed into the internet’s premier source of evidence-based content. Our motto is ‘Find evidence fast’ and this is something we aim to deliver for every single search.

As well as research evidence we also allow clinicians to search across other content types including images, videos, patient information leaflets, educational courses and news.

For further information on Trip click on any of the questions/sections on the left-hand side of this page. But if you still have questions please contact us via jon.brassey@tripdatabase.com

Antibiotics

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.

Trip has extensive coverage of the evidence base on antibiotics allowing users to easily find trusted answers. Coverage include guidelines, systematic reviews, controlled trials and evidence-based synopses.

Top results for antibiotics

1. Antimicrobial prescribing: delafloxacin for acute bacterial skin and skin structure infections

Regulatory Agency (MHRA) or the NICE websites for up-to-date information. Delafloxacin (Quofenix, Menarini) is a fluoroquinolone antibiotic, which is available as a powder for infusion and a tablet. It has a marketing authorisation for treating acute bacterial skin and skin structure infections (ABSSSI) in adults when it is considered inappropriate to use other antibacterial agents that are commonly recommended for the initial treatment of these infections. Advisory statement on likely place in therapy (...) delafloxacin in these circumstances, with a switch to oral treatment after 3 days if possible. T ake account of local antimicrobial resistance and seek specialist microbiological advice. Follow the recommendations on new antimicrobials in the NICE guideline on antimicrobial stewardship. Rationale Rationale The European Public Assessment Report (EPAR) for delafloxacin states that most ABSSSI remain susceptible to penicillin and beta-lactam antibiotics, but antibiotic resistance is becoming more common

2021 National Institute for Health and Clinical Excellence - Advice

2. Antimicrobial prescribing: cefiderocol

antibiotic that is given intravenously. It has a marketing authorisation for the treatment of infections due to aerobic gram- negative organisms in adults with limited treatment options. Advisory statement on likely place in therapy Advisory statement on likely place in therapy Cefiderocol may be an option for treating infections due to gram-negative aerobic organisms in adults who have limited treatment options, particularly when other antimicrobials have failed. T ake account of local antimicrobial (...) in clinical practice in the UK are limited. Information on resistance can be found on Public Health England's antimicrobial resistance local indicators. The SPC for cefiderocol includes details on mechanisms that may lead to resistance. The in vitro antibacterial activity of cefiderocol against normally susceptible species is not affected by most beta-lactamases, including metallo-enzymes. Cefiderocol has little or no activity against most gram-positive organisms and anaerobes. Resource implications

2020 National Institute for Health and Clinical Excellence - Advice

3. Guideline on the prudent prescription of antibiotics in the dental office

2.6.2 Systematic reviews 31 2.6.3 RCTs 31 2.6.4 Non-randomised primary studies 31 2.7 DATA EXTRACTION 32 2.8 STATISTICAL ANALYSES 32 2.9 GRADING EVIDENCE 32 2.10 FORMULATION OF RECOMMENDATIONS 35 2.11 STAKEHOLDER INVOLVEMENT 38 2.11.1 Professional associations 38 2.11.2 Patient representatives 39 2.11.3 Process 40 2.12 FINAL VALIDATION 40 3 ADVERSE EVENTS ASSOCIATED WITH THE USE OF ANTIBIOTICS 41 3.1 ANTIBACTERIAL RESISTANCE 42 3.1.1 Antibacterial resistance, a natural phenomenon 42 3.1.2 How do (...) bacteria become resistant? 42 3.1.3 How does antibiotic resistance spread? 43 3.1.4 The burden of antibacterial resistance 43 3.1.5 The prudent use of antibiotics, an essential element in the battle against antibacterial resistance 47 3.2 DISRUPTION OF THE HUMAN MICROBIOME 47 3.2.1 The human microbiome 47 KCE Report 332 Prescription of antibiotics in the dental office 3 3.2.2 Impact of antibiotics on the human microbiome 48 3.2.3 Clostridioides difficile infection following antibiotic use 48 3.3 DRUG

2020 Belgian Health Care Knowledge Centre

4. Obtaining Blood Cultures Before the Administration of Antibiotics and other Emergency Department Fables: An Analysis of the FABLED Study Full Text available with Trip Pro

obtained before starting antibiotic therapy, and who were able to have additional sets obtained within 2 hours of empirical antimicrobial administration. Severe manifestations of sepsis were defined by 2 SIRS criteria, with a suspected or confirmed infectious source, and either hypotension (systolic blood pressure <90 mm Hg) or a serum lactate level greater than 4 mmol/L. Intervention: Two sets of blood cultures (1 aerobic and 1 anaerobic culture vial in each set) were obtained before antimicrobial (...) administration from separate venipuncture sites. Patients were required to have repeated blood testing for cultures, obtained between 30 and 120 minutes after the initiation of antibiotic therapy. Primary and Secondary Outcomes: Sensitivity of blood culture results obtained after initiation of antimicrobial therapy. Sponsors: Vancouver Coastal Health, St. Paul’s Hospital Foundation Emergency Department Support Fund, the Fonds de recherche Santé–Quebec, and the Maricopa Medical Foundation. ClinicalTrials.gov

2020 Annals of Emergency Medicine Journal Club

5. Pediatric hydrocephalus - Antibiotic-impregnated shunt systems versus conventional shunts in children: a systematic review and meta-analysis

. Journal of neurosurgery Pediatrics. 2008;2(1):25-28. Sciubba DM, Lin LM, Woodworth GF, McGirt MJ, Carson B, Jallo GI. Factors contributing to the medical costs of cerebrospinal fluid shunt infection treatment in pediatric patients with standard shunt components compared with those in patients with antibiotic impregnated components. In: Neurosurg Focus. Vol 22. United States2007:E9. Stone J, Gruber TJ, Rozzelle CJ. Healthcare savings associated with reduced infection rates using antimicrobial suture (...) bacterial catheter-related infection. Journal of neurosurgery. 1997;87(2):247-251. Pattavilakom A, Kotasnas D, Korman TM, Xenos C, Danks A. Duration of in vivo antimicrobial activity of antibiotic-impregnated cerebrospinal fluid catheters. In: Neurosurgery. Vol 58. United States2006:930-935; discussion 930-935. Albanese A, De Bonis P, Sabatino G, et al. Antibiotic-impregnated ventriculo-peritoneal shunts in patients at high risk of infection. Acta neurochirurgica. 2009;151(10):1259-1263. Aryan HE

2020 Congress of Neurological Surgeons

6. ClearGuard HD Antimicrobial Barrier Cap for preventing haemodialysis catheter-related bloodstream infections

port or vascular access device catheter hub before and after accessing the system using 2% chlorhexidine gluconate in 70% alcohol. The hub should be cleaned for 15 seconds and allowed to dry before access. If the manufacturer's recommendations prohibit the use of alcohol with their catheter, an aqueous solution of chlorhexidine gluconate should be considered. The recommendations also state that antibiotic lock solutions and systemic antimicrobial prophylaxis should not be used routinely to prevent (...) ClearGuard HD Antimicrobial Barrier Cap for preventing haemodialysis catheter-related bloodstream infections ClearGuard HD Antimicrobial Barrier Cap for preventing haemodialysis catheter-related bloodstream infections Medtech innovation briefing Published: 3 November 2020 www.nice.org.uk/guidance/mib234 pathways Summary Summary • The technology technology described in this briefing is ClearGuard HD Antimicrobial Barrier Cap. It is a central venous catheter cap with chlorhexidine acetate coated

2020 National Institute for Health and Clinical Excellence - Advice

7. Antimicrobial prescribing: imipenem with cilastatin and relebactam

information. Imipenem with cilastatin and relebactam (Recarbrio, Merck Sharp & Dohme B.V) is given intravenously and is a combination of a broad-spectrum carbapenem antibiotic (imipenem); an inhibitor of dehydropeptidase-I, the renal enzyme that metabolises and inactivates imipenem (cilastatin); and a beta-lactamase inhibitor (relebactam). Only imipenem has antibacterial activity. Imipenem with cilastatin and relebactam has a marketing authorisation for treating infections caused by aerobic gram-negative (...) Antimicrobial prescribing: imipenem with cilastatin and relebactam Antimicrobial prescribing: imipenem with cilastatin and relebactam Evidence summary Published: 28 October 2020 www.nice.org.uk/guidance/es30 pathways Product overview Product overview The content of this evidence summary was up-to-date in October 2020. See summaries of product characteristics (SPCs), British national formulary (BNF) or the Medicines and Healthcare products Regulatory Agency (MHRA) or NICE websites for up-to-date

2020 National Institute for Health and Clinical Excellence - Advice

8. Antimicrobial-impregnated central venous catheters for preventing neonatal bloodstream infection: the PREVAIL RCT Full Text available with Trip Pro

Antimicrobial-impregnated central venous catheters for preventing neonatal bloodstream infection: the PREVAIL RCT Antimicrobial-impregnated central venous catheters for preventing neonatal bloodstream infection: the PREVAIL RCT Journals Library An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could not be found. Please choose a page from the navigation or try a website search above to find

2020 NIHR HTA programme

9. Human and animal bites: antimicrobial prescribing

and committee details 27 Human and animal bites: antimicrobial prescribing (NG184) © NICE 2020. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 27Overview Overview This guideline sets out an antimicrobial prescribing strategy for human and animal bites (excluding insect bites) in adults, young people and children aged 72 hours and over. It aims to optimise antibiotic use and reduce antibiotic resistance. See a 3-page visual summary (...) ), that you are unfamiliar with. For a short explanation of why the committee made these recommendations, see the rationale section on assessment. For more details, see the evidence review. Human and animal bites: antimicrobial prescribing (NG184) © NICE 2020. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 5 of 27Antibiotic prophylaxis for uninfected bites Antibiotic prophylaxis for uninfected bites Human bites Human bites 1.1.4 Do

2020 National Institute for Health and Clinical Excellence - Clinical Guidelines

10. A Randomized Trial Comparing Antibiotics with Appendectomy for Appendicitis. (Abstract)

A Randomized Trial Comparing Antibiotics with Appendectomy for Appendicitis. Antibiotic therapy has been proposed as an alternative to surgery for the treatment of appendicitis.We conducted a pragmatic, nonblinded, noninferiority, randomized trial comparing antibiotic therapy (10-day course) with appendectomy in patients with appendicitis at 25 U.S. centers. The primary outcome was 30-day health status, as assessed with the European Quality of Life-5 Dimensions (EQ-5D) questionnaire (scores (...) range from 0 to 1, with higher scores indicating better health status; noninferiority margin, 0.05 points). Secondary outcomes included appendectomy in the antibiotics group and complications through 90 days; analyses were prespecified in subgroups defined according to the presence or absence of an appendicolith.In total, 1552 adults (414 with an appendicolith) underwent randomization; 776 were assigned to receive antibiotics (47% of whom were not hospitalized for the index treatment) and 776

2020 NEJM

11. Appendectomy versus antibiotic treatment for acute appendicitis. (Abstract)

Appendectomy versus antibiotic treatment for acute appendicitis. This Cochrane review has been withdrawn. The Cochrane review is out of date and included a retracted article in the analysis. Withdrawn by Cochrane Colorectal Group. A new update is expected. The editorial group responsible for this previously published document have withdrawn it from publication.Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

2020 Cochrane

12. Insect bites and stings: antimicrobial prescribing

bites and stings 5 T erms used in the guideline 7 Rationales 9 Assessment and advice 9 Treatment 9 Referral and seeking specialist advice 10 Context 12 Summary of the evidence 13 Antibiotics for infected arthropod bites in adults 13 Oral antihistamines for uninfected mosquito bites in adults 14 Antihistamines for uninfected mosquito bites in children 15 Treatments for uninfected brown recluse spider bites 15 Insect bites and stings: antimicrobial prescribing (NG182) © NICE 2020. All rights reserved (...) . Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 16Overview Overview This guideline sets out an antimicrobial prescribing strategy for insect and spider bites and stings in adults, young people and children aged 72 hours and over, including those that occurred while travelling outside the UK. It aims to limit antibiotic use and reduce antibiotic resistance. See a 1-page visual summary of the recommendations. The recommendations in this guideline

2020 National Institute for Health and Clinical Excellence - Clinical Guidelines

13. Prophylactic anti-staphylococcal antibiotics for cystic fibrosis. Full Text available with Trip Pro

Prophylactic anti-staphylococcal antibiotics for cystic fibrosis. Staphylococcus aureus causes pulmonary infection in young children with cystic fibrosis. Prophylactic antibiotics are prescribed hoping to prevent such infection and lung damage. Antibiotics have adverse effects and long-term use might lead to infection with Pseudomonas aeruginosa. This is an update of a previously published review.To assess continuous oral antibiotic prophylaxis to prevent the acquisition of Staphylococcus (...) aureus versus no prophylaxis in people with cystic fibrosis, we tested the following hypotheses to investigate whether prophylaxis: 1. improves clinical status, lung function and survival; 2. leads to fewer isolates of Staphylococcus aureus; 3. causes adverse effects (e.g. diarrhoea, skin rash, candidiasis); 4. leads to fewer isolates of other common pathogens from respiratory secretions; 5. leads to the emergence of antibiotic resistance and colonisation of the respiratory tract with Pseudomonas

2020 Cochrane

14. Infectious Diseases Society of America Guidance on the Treatment of Antimicrobial Resistant Gram-Negative Infections

, antimicrobial resistant pathogens caused more than 2.8 million infections and over 35,000 deaths annually in the United States from 2012 through 2017, according to the 2019 Centers for Disease Control and Prevention (CDC) Antibiotic Resistant Threats Report [2]. The selection of effective antibiotics for the treatment of infections by resistant pathogens is challenging [3]. Although there has been an increase in the availability of novel antibiotics to combat resistant infections in recent years [3 (...) will be disseminated on multiple platforms and updated as new data emerge. Treatment of antimicrobial resistant Gram-negative bacterial infections was chosen as the initial topic for a guidance document. The overarching goal of this guidance document is to assist clinicians – including those with and without infectious diseases expertise – in selecting antibiotic therapy for infections caused by ESBL-E, CRE, and DTR- P. aeruginosa . Future iterations of this document will address other resistant pathogens

2020 Infectious Diseases Society of America

15. FSRH CEU Response to study: Analysis of reports of unintended pregnancies associated with the combined use of non-enzyme inducing antibiotics and hormonal contraceptives

FSRH CEU Response to study: Analysis of reports of unintended pregnancies associated with the combined use of non-enzyme inducing antibiotics and hormonal contraceptives 1 FSRH CEU Response to study: Analysis of reports of unintended pregnancies associated with the combined use of non-enzyme inducing antibiotics and hormonal contraceptives 19 August 2020 The BMJ Evidence Based Medicine Journal has published a paper 1 suggesting that antibiotics may lessen the effectiveness of hormonal (...) contraception. The authors used the ‘Yellow Cards’ system where clinicians and patients can report adverse drug side-effects to the UK’s drug and medical devices regulator, the Medicines and Healthcare products Regulatory Agency (MHRA). Data between 1963 and July 2018 was analysed and researchers compared the number of unintended pregnancies reported in 74,623 Yellow Cards for antibiotics in general and in 32,872 for enzyme-inducing drugs with those reported in 65,578 other types of drugs in users of oral

2020 Faculty of Sexual & Reproductive Healthcare

16. Antimicrobial mouthwashes (gargling) and nasal sprays to protect healthcare workers when undertaking aerosol generating procedures (AGPs) on patients without suspected or confirmed Covid-19 infection

, prevent tooth decay and reduce plaque formation. In some countries they are recommended as a hygiene measure during the regular cold and flu season. Many mouthwashes with some antimicrobial activity can be purchased over the counter, and others are available on prescription. The antimicrobial agents and effectiveness vary and whilst most have some antibacterial properties a few are also antiviral. Similar topical antimicrobial solutions may be administered via the nose using a nasal spray (...) Antimicrobial mouthwashes (gargling) and nasal sprays to protect healthcare workers when undertaking aerosol generating procedures (AGPs) on patients without suspected or confirmed Covid-19 infection Antimicrobial mouthwashes (gargling) and nasal sprays to protect healthcare workers when undertaking aerosol‐generating procedures (AGPs) on patients without suspected or confirmed COVID‐19 infection - Burton, MJ - 2020 | Cochrane Library Cookies Our site uses cookies to improve your experience

2020 Cochrane

17. Antimicrobial mouthwashes (gargling) and nasal sprays administered to patients with suspected or confirmed Covid-19 infection to protect healthcare workers treating them

of the intervention Mouthwashes are oral rinsing solutions: many are in common use to manage halitosis, prevent tooth decay and reduce plaque formation. In some countries they are recommended as a hygiene measure during the regular cold and flu season. Many mouthwashes with some antimicrobial activity can be purchased over the counter, and others are available on prescription. The antimicrobial agents and effectiveness vary and whilst most have some antibacterial properties a few are also antiviral. Similar (...) Antimicrobial mouthwashes (gargling) and nasal sprays administered to patients with suspected or confirmed Covid-19 infection to protect healthcare workers treating them Antimicrobial mouthwashes (gargling) and nasal sprays administered to patients with suspected or confirmed COVID‐19 infection to improve patient outcomes and to protect healthcare workers treating them - Burton, MJ - 2020 | Cochrane Library Cookies Our site uses cookies to improve your experience. You can find out more about

2020 Cochrane

18. Use of antimicrobial mouthwashes (gargling) and nasal sprays by healthcare workers to protect them when treating patients with suspected or confirmed Covid-19

season. Many mouthwashes with some antimicrobial activity can be purchased over the counter, and others are available on prescription. The antimicrobial agents and effectiveness vary and whilst most have some antibacterial properties a few are also antiviral. Similar topical antimicrobial solutions may be administered via the nose using a nasal spray, or by direct irrigation or douching (administered by sniffing a solution through each nostril and spitting it out). How the intervention might work (...) Use of antimicrobial mouthwashes (gargling) and nasal sprays by healthcare workers to protect them when treating patients with suspected or confirmed Covid-19 Use of antimicrobial mouthwashes (gargling) and nasal sprays by healthcare workers to protect them when treating patients with suspected or confirmed COVID‐19 infection - Burton, MJ - 2020 | Cochrane Library Cookies Our site uses cookies to improve your experience. You can find out more about our use of cookies in About Cookies, including

2020 Cochrane

19. Antibiotic therapy for pelvic inflammatory disease. Full Text available with Trip Pro

Antibiotic therapy for pelvic inflammatory disease. Pelvic inflammatory disease (PID) affects 4% to 12% of women of reproductive age. The main intervention for acute PID is broad-spectrum antibiotics administered intravenously, intramuscularly or orally. We assessed the optimal treatment regimen for PID.  OBJECTIVES: To assess the effectiveness and safety of antibiotic regimens to treat PID.In January 2020, we searched the Cochrane Sexually Transmitted Infections Review Group's Specialized (...) Register, which included randomized controlled trials (RCTs) from 1944 to 2020, located through hand and electronic searching; CENTRAL; MEDLINE; Embase; four other databases; and abstracts in selected publications.We included RCTs comparing antibiotics with placebo or other antibiotics for the treatment of PID in women of reproductive age, either as inpatient or outpatient treatment. We limited our review to a comparison of drugs in current use that are recommended by the 2015 US Centers for Disease

2020 Cochrane

20. Association of Nonoperative Management Using Antibiotic Therapy vs Laparoscopic Appendectomy With Treatment Success and Disability Days in Children With Uncomplicated Appendicitis. (Abstract)

Association of Nonoperative Management Using Antibiotic Therapy vs Laparoscopic Appendectomy With Treatment Success and Disability Days in Children With Uncomplicated Appendicitis. Nonoperative management with antibiotics alone has the potential to treat uncomplicated pediatric appendicitis with fewer disability days than surgery.To determine the success rate of nonoperative management and compare differences in treatment-related disability, satisfaction, health-related quality of life (...) with antibiotics alone (nonoperative group, n = 370) or urgent (≤12 hours of admission) laparoscopic appendectomy (surgery group, n = 698).The 2 primary outcomes assessed at 1 year were disability days, defined as the total number of days the child was not able to participate in all of his/her normal activities secondary to appendicitis-related care (expected difference, 5 days), and success rate of nonoperative management, defined as the proportion of patients initially managed nonoperatively who did

2020 JAMA