Latest & greatest articles for antibiotics

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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.

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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

23. The Effect of Prolonged Postoperative Antibiotic Administration on the Rate of Infection in Patients Undergoing Posterior Spinal Surgery Requiring a Closed-Suction Drain: A Randomized Controlled Trial (Abstract)

The Effect of Prolonged Postoperative Antibiotic Administration on the Rate of Infection in Patients Undergoing Posterior Spinal Surgery Requiring a Closed-Suction Drain: A Randomized Controlled Trial Closed-suction drains are frequently used following posterior spinal surgery. The optimal timing of antibiotic discontinuation in this population may influence infection risk, but there is a paucity of evidence. The aim of this study was to determine whether postoperative antibiotic administration (...) for 72 hours (24 hours after drain removal as drains were removed on the second postoperative day) decreases the incidence of surgical site infection compared with postoperative antibiotic administration for 24 hours.Patients undergoing posterior thoracolumbar spinal surgery managed with a closed-suction drain were prospectively randomized into 1 of 2 groups of postoperative antibiotic durations: (1) 24 hours, or (2) 24 hours after drain removal (72 hours). Drains were discontinued on the second

2019 EvidenceUpdates

24. Antibiotics for treating osteomyelitis in people with sickle cell disease. (Abstract)

Antibiotics for treating osteomyelitis in people with sickle cell disease. Osteomyelitis (both acute and chronic) is one of the most common infectious complications in people with sickle cell disease. There is no standardized approach to antibiotic therapy and treatment is likely to vary from country to country. Thus, there is a need to identify the efficacy and safety of different antibiotic treatment approaches for people with sickle cell disease suffering from osteomyelitis (...) . This is an update of a previously published Cochrane Review.To determine whether an empirical antibiotic treatment approach (monotherapy or combination therapy) is effective and safe as compared to pathogen-directed antibiotic treatment and whether this effectiveness and safety is dependent on different treatment regimens, age or setting.We searched The Group's Haemoglobinopathies Trials Register, which comprises references identified from comprehensive electronic database searches and handsearching of relevant

2019 Cochrane

25. Probiotics for Antibiotic-Associated Diarrhea in Pediatrics: A Review of Clinical Effectiveness and Guidelines

Probiotics for Antibiotic-Associated Diarrhea in Pediatrics: A Review of Clinical Effectiveness and Guidelines Probiotics for Antibiotic-Associated Diarrhea in Pediatrics: A Review of Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Probiotics for Antibiotic-Associated Diarrhea in Pediatrics: A Review of Clinical Effectiveness and Guidelines Probiotics for Antibiotic-Associated Diarrhea in Pediatrics: A Review of Clinical Effectiveness and Guidelines Last updated (...) : March 25, 2019 Project Number: RC1086-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of probiotics (with or without concurrent antibiotics) for preventing and treating antibiotic-associated diarrhea in the pediatric population? What are the evidence-based guidelines regarding the use of probiotics (with or without concurrent antibiotics) for the prevention and treatment of antibiotic-associated

2019 Canadian Agency for Drugs and Technologies in Health - Rapid Review

26. Biologics versus Immunomodulators or Antibiotics for the Management of Fistulizing Crohn’s Disease: A Review of Comparative Clinical Effectiveness and Cost-Effectiveness

Biologics versus Immunomodulators or Antibiotics for the Management of Fistulizing Crohn’s Disease: A Review of Comparative Clinical Effectiveness and Cost-Effectiveness Biologics versus Immunomodulators or Antibiotics for the Management of Fistulizing Crohn’s Disease: A Review of Comparative Clinical Effectiveness and Cost-Effectiveness | CADTH.ca Find the information you need Biologics versus Immunomodulators or Antibiotics for the Management of Fistulizing Crohn’s Disease: A Review (...) of Comparative Clinical Effectiveness and Cost-Effectiveness Biologics versus Immunomodulators or Antibiotics for the Management of Fistulizing Crohn’s Disease: A Review of Comparative Clinical Effectiveness and Cost-Effectiveness Last updated: March 29, 2019 Project Number: RC1107-000 - RD0051-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Question What is the comparative clinical effectiveness of biologics (with or without concomitant immunomodulators

2019 Canadian Agency for Drugs and Technologies in Health - Rapid Review

27. Pneumonia (hospital-acquired): antimicrobial prescribing

of 23Contents Contents Overview 4 Who is it for? 4 Recommendations 5 1.1 Managing hospital-acquired pneumonia 5 1.2 Choice of antibiotic 6 T erms used in the guideline 13 Hospital-acquired pneumonia 13 Summary of the evidence 14 Antibiotic prescribing strategies 14 Choice of antibiotics 15 Antibiotic course length, dosage and route of administration 22 Other considerations 23 Medicines adherence 23 Resource implications 23 Pneumonia (hospital-acquired): antimicrobial prescribing (NG139) © NICE 2019. All (...) rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 23Ov Overview erview This guideline sets out an antimicrobial prescribing strategy for adults, young people, children and babies aged 72 hours and over with a confirmed diagnosis of hospital-acquired pneumonia. It does not cover ventilator-associated pneumonia. It aims to optimise antibiotic use and reduce antibiotic resistance. See a 3-page visual summary of the recommendations

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

28. Pneumonia (community-acquired): antimicrobial prescribing

37 Resource implications 37 Pneumonia (community-acquired): antimicrobial prescribing (NG138) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 37Ov Overview erview This guideline sets out an antimicrobial prescribing strategy for adults, young people, children and babies aged 72 hours and over with a confirmed diagnosis of community-acquired pneumonia. It aims to optimise antibiotic use and reduce antibiotic (...) disease or immunosuppression local antimicrobial resistance and surveillance data (such as flu and Mycoplasma pneumoniae infection rates) recent antibiotic use recent microbiological results, including colonisation with multidrug-resistant bacteria. 1.1.2 Start antibiotic treatment as soon as possible after establishing a diagnosis of community-acquired pneumonia, and certainly within 4 hours (within 1 hour if the person has suspected sepsis and meets any of the high risk criteria for this – see

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

29. Cellulitis and erysipelas: antimicrobial prescribing

. It aims to optimise antibiotic use and reduce antibiotic resistance. See a 3-page visual summary of the recommendations, including tables to support prescribing decisions. For managing other skin conditions, see our web page on skin conditions. NICE has also produced a guideline on antimicrobial stewardship: systems and processes for effective antimicrobial medicine use. Who is it for? Healthcare professionals People with cellulitis and erysipelas, their families and carers Cellulitis and erysipelas (...) Staphylococcus aureus (MRSA) status if known. 1.1.5 Give oral antibiotics first line if the person can take oral medicines, and the severity of their condition does not require intravenous antibiotics. Cellulitis and erysipelas: antimicrobial prescribing (NG141) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 5 of 361.1.6 If intravenous antibiotics are given, review by 48 hours and consider switching to oral antibiotics

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

30. Antibiotic awareness: important messages on antibiotic use

Antibiotic awareness: important messages on antibiotic use Antibiotic awareness: important messages on antibiotic use - GOV.UK GOV.UK uses cookies which are essential for the site to work. We also use non-essential cookies to help us improve government digital services. Any data collected is anonymised. By continuing to use this site, you agree to our use of cookies. Accept cookies You’ve accepted all cookies. You can at any time. Hide Search Guidance Antibiotic awareness: important messages (...) on antibiotic use This document explains how to use antibiotics responsibly for patients, animal keepers, pet owners and prescribers. Published 23 September 2014 Last updated 7 October 2019 — From: Documents Ref: PHE publication gateway reference: GW-779 If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email . Please tell us what format you need. It will help us if you say what assistive technology you use. Details PHE has

2019 Public Health England

31. Effect of Bismuth Subsalicylate vs Placebo on Use of Antibiotics Among Adult Outpatients With Diarrhea in Pakistan: A Randomized Clinical Trial Full Text available with Trip Pro

Effect of Bismuth Subsalicylate vs Placebo on Use of Antibiotics Among Adult Outpatients With Diarrhea in Pakistan: A Randomized Clinical Trial Many of the 4.5 billion annual episodes of diarrhea are treated unnecessarily with antibiotics; prevalence of antibiotic resistance among diarrheal pathogens is increasing. Knowledge-based antibiotic stewardship interventions typically yield little change in antibiotic use.To compare antibiotic use among adult outpatients with diarrhea given bismuth (...) assigned (1:1) to receive BSS or placebo for 48 hours or less.Use of systemic antibiotics within 5 days of enrollment. Secondary outcomes included measures of duration and severity of illness.Among eligible patients, 39 declined to participate, 440 enrolled, and 1 enrolled participant was lost to follow-up, for a total of 439 patients included in the analysis. Median (interquartile range) participant age was 32 (23-45) years and 187 (43%) were male. Two hundred twenty patients were randomized to BSS

2019 EvidenceUpdates

32. Prophylactic antibiotics to prevent surgical site infection after breast cancer surgery. (Abstract)

Prophylactic antibiotics to prevent surgical site infection after breast cancer surgery. Surgery has been used as part of breast cancer treatment for centuries; however any surgical procedure has the potential risk of infection. Infection rates for surgical treatment of breast cancer are documented at between 3% and 15%, higher than average for a clean surgical procedure. Pre- and perioperative antibiotics have been found to be useful in lowering infection rates in other surgical groups, yet (...) there is no consensus on the use of prophylactic antibiotics for breast cancer surgery. This is an update of a Cochrane Review first published in 2005 and last updated in 2014.To determine the effects of prophylactic (pre- or perioperative) antibiotics on the incidence of surgical site infection (SSI) after breast cancer surgery.For this fourth update, in August 2018 we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including In-Process

2019 Cochrane

33. Antibiotics for trachoma. (Abstract)

, and it was difficult to judge risk of bias.There was low-certainty evidence of little or no difference in effect between oral and topical antibiotics on active trachoma at three months (RR 0.97, 95% CI 0.81 to 1.16; 953 people; 6 RCTs; I2 = 63%) and 12 months (RR 0.93, 95% CI 0.75 to 1.15; 886 people; 5 RCTs; I2 = 56%). There was very low-certainty evidence for ocular infection at three or 12 months. Antimicrobial resistance was not assessed. In those studies that reported adverse effects, no serious adverse (...) Antibiotics for trachoma. Trachoma is the world's leading infectious cause of blindness. In 1996, WHO launched the Alliance for the Global Elimination of Trachoma by the year 2020, based on the 'SAFE' strategy (surgery, antibiotics, facial cleanliness, and environmental improvement).To assess the evidence supporting the antibiotic arm of the SAFE strategy by assessing the effects of antibiotics on both active trachoma (primary objective), Chlamydia trachomatis infection of the conjunctiva

2019 Cochrane

34. Antibiotics for treating acute chest syndrome in people with sickle cell disease. (Abstract)

Antibiotics for treating acute chest syndrome in people with sickle cell disease. The clinical presentation of acute chest syndrome is similar whether due to infectious or non-infectious causes, thus antibiotics are usually prescribed to treat all episodes. Many different pathogens, including bacteria, have been implicated as causative agents of acute chest syndrome. There is no standardized approach to antibiotic therapy and treatment is likely to vary from country to country. Thus (...) , there is a need to identify the efficacy and safety of different antibiotic treatment approaches for people with sickle cell disease suffering from acute chest syndrome. This is an update of a Cochrane Review first published in 2007, and most recently updated in 2015.To determine whether an empirical antibiotic treatment approach (used alone or in combination):1. is effective for acute chest syndrome compared to placebo or standard treatment;2. is safe for acute chest syndrome compared to placebo or standard

2019 Cochrane

35. Blood Culture Results Before and After Antimicrobial Administration in Patients With Severe Manifestations of Sepsis: A Diagnostic Study. (Abstract)

Blood Culture Results Before and After Antimicrobial Administration in Patients With Severe Manifestations of Sepsis: A Diagnostic Study. Administering antimicrobial agents before obtaining blood cultures could potentially decrease time to treatment and improve outcomes, but it is unclear how this strategy affects diagnostic sensitivity.To determine the sensitivity of blood cultures obtained shortly after initiation of antimicrobial therapy in patients with severe manifestations (...) of sepsis.Patient-level, single-group, diagnostic study. (ClinicalTrials.gov: NCT01867905).7 emergency departments in North America.Adults with severe manifestations of sepsis, including systolic blood pressure less than 90 mm Hg or a serum lactate level of 4 mmol/L or more.Blood cultures were obtained before and within 120 minutes after initiation of antimicrobial treatment.Sensitivity of blood cultures obtained after initiation of antimicrobial therapy.Of 3164 participants screened, 325 were included

2019 Annals of Internal Medicine

36. Antibiotic or silver versus standard ventriculoperitoneal shunts (BASICS): a multicentre, single-blinded, randomised trial and economic evaluation. Full Text available with Trip Pro

Antibiotic or silver versus standard ventriculoperitoneal shunts (BASICS): a multicentre, single-blinded, randomised trial and economic evaluation. Insertion of a ventriculoperitoneal shunt for hydrocephalus is one of the commonest neurosurgical procedures worldwide. Infection of the implanted shunt affects up to 15% of these patients, resulting in prolonged hospital treatment, multiple surgeries, and reduced cognition and quality of life. Our aim was to determine the clinical and cost (...) -effectiveness of antibiotic (rifampicin and clindamycin) or silver shunts compared with standard shunts at reducing infection.In this parallel, multicentre, single-blind, randomised controlled trial, we included patients with hydrocephalus of any aetiology undergoing insertion of their first ventriculoperitoneal shunt irrespective of age at 21 regional adult and paediatric neurosurgery centres in the UK and Ireland. Patients were randomly assigned (1:1:1 in random permuted blocks of three or six) to receive

2019 Lancet

37. Mechanical and oral antibiotic bowel preparation versus no bowel preparation for elective colectomy (MOBILE): a multicentre, randomised, parallel, single-blinded trial. (Abstract)

Mechanical and oral antibiotic bowel preparation versus no bowel preparation for elective colectomy (MOBILE): a multicentre, randomised, parallel, single-blinded trial. Decreased surgical site infections (SSIs) and morbidity have been reported with mechanical and oral antibiotic bowel preparation (MOABP) compared with no bowel preparation (NBP) in colonic surgery. Several societies have recommended routine use of MOABP in patients undergoing colon resection on the basis of these data. Our aim

2019 Lancet Controlled trial quality: predicted high

38. Duration of intravenous antibiotic therapy in people with cystic fibrosis. (Abstract)

Duration of intravenous antibiotic therapy in people with cystic fibrosis. Progressive lung damage from recurrent exacerbations is the major cause of mortality and morbidity in cystic fibrosis. Life expectancy of people with cystic fibrosis has increased dramatically in the last 40 years. One of the major reasons for this increase is the mounting use of antibiotics to treat chest exacerbations caused by bacterial infections. The optimal duration of intravenous antibiotic therapy is not clearly (...) defined. Individuals usually receive intravenous antibiotics for 14 days, but treatment may range from 10 to 21 days. A shorter duration of antibiotic treatment risks inadequate clearance of infection which could lead to further lung damage. Prolonged courses of intravenous antibiotics are expensive and inconvenient. The risk of systemic side effects such as allergic reactions to antibiotics also increases with prolonged courses and the use of aminoglycosides requires frequent monitoring to minimise

2019 Cochrane

39. Respiratory tract infections (self-limiting) – reducing antibiotic prescribing

in the event of a significant clinical deterioration. Sore throat/pharyngitis/tonsillitis has been excluded from the contextualised guideline for two reasons: (i) in contrast to the UK, New Zealand has a relatively high incidence of rheumatic fever and therefore the risks of not prescribing an antibiotic treatment for many patients with sore throat are very much greater; and (ii) in New Zealand there are widely used guidelines that recommend antimicrobial treatment for patients with sore throat who (...) Otitis Media. Diagnosis and Management of Acute Otitis Media. Pediatrics, 2004 113(5), 1451-65. 2. McGregor A, Dovey S, Tilyard M. Antibiotic use in upper respiratory tract infections in New Zealand. Family Practice 1995;12:166-70. 3. Thomas MG, Smith AJ, Tilyard M. Rising antimicrobial resistance: a strong reason to reduce antimicrobial consumption in New Zealand. NZ Med J 2014;127:1394:72-84. 4. Heart Foundation of New Zealand: Guidelines for Group A Streptococcal Sore Throat Management Guideline

2019 Best Practice Advocacy Centre New Zealand

40. Long-term follow-up of the AVOD randomized trial of antibiotic avoidance in uncomplicated diverticulitis (Abstract)

Long-term follow-up of the AVOD randomized trial of antibiotic avoidance in uncomplicated diverticulitis The aim of this study was to assess the long-term results in patients with uncomplicated diverticulitis who had participated in the Antibiotics in Acute Uncomplicated Diverticulitis (AVOD) RCT, which randomized patients with CT-verified left-sided acute uncomplicated diverticulitis to management without or with antibiotics.The medical records of patients who had participated in the AVOD (...) trial were reviewed for long-term results such as recurrences, complications and surgery. Quality-of-life questionnaires (EQ-5D™) were sent to patients, who were also contacted by telephone. Descriptive statistics were used for the analysis of clinical outcomes.A total of 556 of the 623 patients (89·2 per cent) were followed up for a median of 11 years. There were no differences between the no-antibiotic and antibiotic group in recurrences (both 31·3 per cent; P = 0·986), complications (4·4 versus 5

2019 EvidenceUpdates