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

61. Antibacterial Envelope to Prevent Cardiac Implantable Device Infection. Full Text available with Trip Pro

Antibacterial Envelope to Prevent Cardiac Implantable Device Infection. Infections after placement of cardiac implantable electronic devices (CIEDs) are associated with substantial morbidity and mortality. There is limited evidence on prophylactic strategies, other than the use of preoperative antibiotics, to prevent such infections.We conducted a randomized, controlled clinical trial to assess the safety and efficacy of an absorbable, antibiotic-eluting envelope in reducing the incidence (...) of infection associated with CIED implantations. Patients who were undergoing a CIED pocket revision, generator replacement, or system upgrade or an initial implantation of a cardiac resynchronization therapy defibrillator were randomly assigned, in a 1:1 ratio, to receive the envelope or not. Standard-of-care strategies to prevent infection were used in all patients. The primary end point was infection resulting in system extraction or revision, long-term antibiotic therapy with infection recurrence

2019 NEJM Controlled trial quality: predicted high

62. A Randomized Trial of Prophylactic Antibiotics for Miscarriage Surgery. Full Text available with Trip Pro

A Randomized Trial of Prophylactic Antibiotics for Miscarriage Surgery. Surgical intervention is needed in some cases of spontaneous abortion to remove retained products of conception. Antibiotic prophylaxis may reduce the risk of pelvic infection, which is an important complication of this surgery, particularly in low-resource countries.We conducted a double-blind, placebo-controlled, randomized trial investigating whether antibiotic prophylaxis before surgery to complete a spontaneous (...) of these features and the clinically identified need to administer antibiotics. The definition of pelvic infection was changed before the unblinding of the data; the original strict definition was two or more of the clinical features, without reference to the administration of antibiotics.We enrolled 3412 patients in Malawi, Pakistan, Tanzania, and Uganda. A total of 1705 patients were assigned to receive antibiotics and 1707 to receive placebo. The risk of pelvic infection was 4.1% (68 of 1676 pregnancies

2019 NEJM Controlled trial quality: predicted high

63. Antibiotic management of urinary tract infection in elderly patients in primary care and its association with bloodstream infections and all cause mortality: population based cohort study. Full Text available with Trip Pro

Antibiotic management of urinary tract infection in elderly patients in primary care and its association with bloodstream infections and all cause mortality: population based cohort study. To evaluate the association between antibiotic treatment for urinary tract infection (UTI) and severe adverse outcomes in elderly patients in primary care.Retrospective population based cohort study.Clinical Practice Research Datalink (2007-15) primary care records linked to hospital episode statistics (...) and death records in England.157 264 adults aged 65 years or older presenting to a general practitioner with at least one diagnosis of suspected or confirmed lower UTI from November 2007 to May 2015.Bloodstream infection, hospital admission, and all cause mortality within 60 days after the index UTI diagnosis.Among 312 896 UTI episodes (157 264 unique patients), 7.2% (n=22 534) did not have a record of antibiotics being prescribed and 6.2% (n=19 292) showed a delay in antibiotic prescribing. 1539

2019 BMJ

64. Duration of antibiotic treatment for common infections in English primary care: cross sectional analysis and comparison with guidelines. Full Text available with Trip Pro

Duration of antibiotic treatment for common infections in English primary care: cross sectional analysis and comparison with guidelines. To evaluate the duration of prescriptions for antibiotic treatment for common infections in English primary care and to compare this with guideline recommendations.Cross sectional study.General practices contributing to The Health Improvement Network database, 2013-15.931 015 consultations that resulted in an antibiotic prescription for one of several (...) indications: acute sinusitis, acute sore throat, acute cough and bronchitis, pneumonia, acute exacerbation of chronic obstructive pulmonary disease (COPD), acute otitis media, acute cystitis, acute prostatitis, pyelonephritis, cellulitis, impetigo, scarlet fever, and gastroenteritis.The main outcomes were the percentage of antibiotic prescriptions with a duration exceeding the guideline recommendation and the total number of days beyond the recommended duration for each indication.The most common reasons

2019 BMJ

65. Effectiveness and safety of electronically delivered prescribing feedback and decision support on antibiotic use for respiratory illness in primary care: REDUCE cluster randomised trial. Full Text available with Trip Pro

in the Clinical Practice Research Datalink, randomised between 11 November 2015 and 9 August 2016, with final follow-up on 9 August 2017.79 general practices (582 675 patient years) randomised (1:1) to antimicrobial stewardship (AMS) intervention or usual care.AMS intervention comprised a brief training webinar, automated monthly feedback reports of antibiotic prescribing, and electronic decision support tools to inform appropriate prescribing over 12 months. Intervention components were delivered (...) Effectiveness and safety of electronically delivered prescribing feedback and decision support on antibiotic use for respiratory illness in primary care: REDUCE cluster randomised trial. To evaluate the effectiveness and safety at population scale of electronically delivered prescribing feedback and decision support interventions at reducing antibiotic prescribing for self limiting respiratory tract infections.Open label, two arm, cluster randomised controlled trial.UK general practices

2019 BMJ Controlled trial quality: predicted high

66. Cough (acute): antimicrobial prescribing

1.1 Managing acute cough 5 1.2 Self-care 8 1.3 Choice of antibiotic 9 T erms used in the guideline 11 Acute cough 11 Acute bronchitis 11 Self-care treatments 11 Summary of the evidence 12 Self-care 12 Bronchodilators 22 Corticosteroids 23 Mucolytics 24 No antibiotic 25 Back-up antibiotics 29 Choice of antibiotic 33 Antibiotic course length 35 Other considerations 36 Medicines adherence 36 Resource implications 36 Cough (acute): antimicrobial prescribing (NG120) © NICE 2019. All rights reserved (...) . Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 36Ov Overview erview This guideline sets out an antimicrobial prescribing strategy for acute cough associated with an upper respiratory tract infection or acute bronchitis in adults, young people and children. It aims to limit antibiotic use and reduce antibiotic resistance. See a 2-page visual summary of the recommendations, including tables to support prescribing decisions. For treating coughs

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

67. There?s Pus About, So Are Antibiotics In or Out? Adding antibiotics for abscess management

There?s Pus About, So Are Antibiotics In or Out? Adding antibiotics for abscess management Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 5,000 family physicians, family medicine residents, and medical students in Alberta. Established over sixty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education and primary care (...) research. www.acfp.ca January 21, 2019 There’s Pus About, So Are Antibiotics In or Out? Adding antibiotics for abscess management Clinical Question: Does the addition of antibiotics to incision and drainage improve cure rates in single, uncomplicated skin abscesses? Bottom Line: Adding antibiotics that cover MRSA during incision and drainage for a small abscess increases the cure rate from 85% to 92%, meaning an additional one in 15 patients will be cured compared to placebo at one month. Approximately

2019 Tools for Practice

68. Appropriateness of outpatient antibiotic prescribing among privately insured US patients: ICD-10-CM based cross sectional study. Full Text available with Trip Pro

Appropriateness of outpatient antibiotic prescribing among privately insured US patients: ICD-10-CM based cross sectional study. To assess the appropriateness of outpatient antibiotic prescribing for privately insured children and non-elderly adults in the US using a comprehensive classification scheme of diagnosis codes in ICD-10-CM (international classification of diseases-clinical modification, 10th revision), which replaced ICD-9-CM in the US on 1 October 2015.Cross sectional (...) study.MarketScan Commercial Claims and Encounters database, 2016.19.2 million enrollees aged 0-64 years.A classification scheme was developed that determined whether each of the 91 738 ICD-10-CM diagnosis codes "always," "sometimes," or "never" justified antibiotics. For each antibiotic prescription fill, this scheme was used to classify all diagnosis codes in claims during a look back period that began three days before antibiotic prescription fills and ended on the day fills occurred. The main outcome

2019 BMJ

69. Tailored Helicobacter pylori eradication based on prior intake of macrolide antibiotics allows the use of triple therapy with optimal results in an area with high clarithromycin resistance. Full Text available with Trip Pro

Tailored Helicobacter pylori eradication based on prior intake of macrolide antibiotics allows the use of triple therapy with optimal results in an area with high clarithromycin resistance. the previous intake of macrolide antibiotics is associated with a failure to eradicate Helicobacter pylori (H. pylori) with clarithromycin-containing regimens. However, the standard triple therapy achieves eradication rates of over 90% in patients without a previous use of macrolides in our health area

2019 Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva Controlled trial quality: uncertain

70. COPD exacerbation: no systematic use of antibiotics

COPD exacerbation: no systematic use of antibiotics Prescrire IN ENGLISH - Spotlight ''COPD exacerbation: no systematic use of antibiotics'', 1 January 2019 {1} {1} {1} | | > > > COPD exacerbation: no systematic use of antibiotics Spotlight Every month, the subjects in Prescrire’s Spotlight. 100 most recent :  |   |   |   |   |   |   |   |   |  Spotlight COPD exacerbation: no systematic use of antibiotics For episodes (...) of moderate aggravation in patients with chronic obstructive pulmonary disease (COPD), it is preferable to prescribe antibiotics as a first-line treatment only when the suspicion of bacterial infection is reinforced by an increase in sputum purulence. Patients with chronic obstructive pulmonary disease (COPD) are subject to exacerbations of their disease, i.e. episodes of prolonged aggravation. The known causes are mainly viral and bacterial infections. Some exacerbations justify hospitalisation: severe

2019 Prescrire

71. Bronchiectasis (non-cystic fibrosis), acute exacerbation: antimicrobial prescribing

Reassessment 14 Referral and seeking specialist advice 14 Choice of antibiotic for treating an acute exacerbation of bronchiectasis 15 Preventing acute exacerbations of bronchiectasis (non-cystic fibrosis) and choice of antibiotic 17 Bronchiectasis (non-cystic fibrosis), acute exacerbation: antimicrobial prescribing (NG117) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 19Ov Overview erview This guideline sets out (...) an antimicrobial prescribing strategy for managing and preventing acute exacerbations of bronchiectasis (non-cystic fibrosis). 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. NICE has also produced a guideline on antimicrobial stewardship: systems and processes for effective antimicrobial medicine use. Who is it for? Health professionals People with bronchiectasis, their families

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

72. Adult and Pediatric Antibiotic Prophylaxis during Vascular and IR Procedures: A Society of Interventional Radiology Practice Parameter Update Endorsed by the Cardiovascular and Interventional Radological Society of Europe and the Canadian Association for

procedures, including the increasing prevalence of pediatric IR procedures, and the increasing repertoire of antibacterial agents. As was the case for the original guidelines (1), the availability of randomized controlled data regarding antibiotic prophylaxis is lacking in the IR literature. Much data are derived from retrospective reviews From the Department of Diagnostic Radiology (M.A.C.), Oakland University William Beaumont School of Medicine, Royal Oak, Michigan; Department of Radiology (A.S.T (...) to oropharyngeal ?ora, which can potentially seed the skin entry site. This procedure carries a peristomal infection rate of approximately 30% (156). Prophylactic antibiotic therapy is therefore recommended for all patients undergoing this procedure with antimicrobial agents targeting skin and oropharyngeal bacteria, eg, cefazolin followed by oral/enteric cephalexin (156). (New data reviewed, recommendations updated.) Liver Tumor Ablation In 2015, Bhatia et al (157) described a very low incidence of hepatic ab

2019 Society of Interventional Radiology

73. Diarrhoea - antibiotic associated

-related behaviours in the general population . Review and, if appropriate, optimise current prescribing practice and use implementation techniques to ensure prescribing is in line with NICE antimicrobial prescribing guidelines or Public Health England (PHE) guidance on managing common infections in primary care, the Department of Health's guidance Start smart − then focus , local trust antimicrobial guidelines and the Antimicrobial Stewardship in Primary Care collaboration TARGET antibiotics toolkit (...) mechanisms [ ; ; ; ; ]: Disruption of the bowel microbiota and mucosal integrity. As a direct effect of the antibiotic (independent of its antimicrobial effect) — for example erythromycin can increase the rate of gastric emptying by acting as a motilin receptor agonist. Overgrowth of toxin-producing strains of Clostridium difficile (a Gram-positive, spore-forming, anaerobic bacillus) due to disruption of harmless bacteria in the gut. Overgrowth of C. difficile alone does not cause diarrhoea. C. difficile

2019 NICE Clinical Knowledge Summaries

74. Antibiotic allergy. Full Text available with Trip Pro

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

2018 Lancet

75. Triple Antibiotic Solution Promotes Similar Antibacterial Effects as Calcium Hydroxide/2% Chlorhexidine When Used as an Intracanal Medicament

instrumentation and/or irrigation, are effective in canal disinfection. The intracanal antimicrobial efficacy of triple antibiotic formulation is shown to be superior to calcium hydroxide alone, or at least comparable to calcium hydroxide combined with 2% chlorhexidine when assessing antibacterial efficacy and clinical outcomes. Perspective: Randomized clinical trials are currently the highest available evidence comparing use of triple antibiotic paste against other canal medicaments in primary teeth (...) 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

2018 UTHSCSA Dental School CAT Library

76. Chronic obstructive pulmonary disease (acute exacerbation): antimicrobial prescribing

implications 24 Chronic obstructive pulmonary disease (acute exacerbation): antimicrobial prescribing (NG114) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 24This guideline should be read in conjunction with NG115. Ov Overview erview This guideline sets out an antimicrobial prescribing strategy for acute exacerbations of chronic obstructive pulmonary disease (COPD). It aims to optimise antibiotic use and reduce (...) antibiotic resistance. See a 2-page visual summary of the recommendations, including tables to support prescribing decisions. See the NICE guideline on COPD in over 16s for other recommendations on preventing and managing an acute exacerbation of COPD, including self-management. Who is it for? Health professionals People with COPD, their families and carers Chronic obstructive pulmonary disease (acute exacerbation): antimicrobial prescribing (NG114) © NICE 2019. All rights reserved. Subject to Notice

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

77. 2018 IDSA Clinical Practice Guideline for the Management of Outpatient Parenteral Antimicrobial Therapy

to either remain in hospital for IV antibiotic therapy or forgo IV antimicrobial treatment [42–45]. Methodology Panel Composition The last version of the IDSA OPAT Guideline was published in 2004 [1]. For the current update, 1 of the chairs assembled 11 ID physicians from both academic and private practice settings, including 3 pediatric ID physicians who are members of the Pediatric Infectious Diseases Society. Also included were an experienced ID pharmacist, a member of the Infusion Nursing Society (...) to SNFs, sending patients home without a VAD but bringing them to an outpatient facility for each antimicrobial administration, or keeping them in hospital for the duration of their parenteral antibiotic treatment course. It should be noted that there are no data to suggest that the risk of device misuse is any lower in SNFs, where patients have ample opportunity for illicit drug administration. Confirmation about whether PWID are at higher risk of vascular access complications during OPAT and, if so

2018 Infectious Diseases Society of America

78. Advances in optimizing the prescription of antibiotics in outpatient settings. Full Text available with Trip Pro

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

2018 BMJ

79. The endogenous antimicrobial cathelicidin LL37 induces platelet activation and augments thrombus formation Full Text available with Trip Pro

The endogenous antimicrobial cathelicidin LL37 induces platelet activation and augments thrombus formation Platelet-associated complications including thrombosis, thrombocytopenia, and hemorrhage are commonly observed during various inflammatory diseases such as sepsis, inflammatory bowel disease, and psoriasis. Despite the reported evidence on numerous mechanisms/molecules that may contribute to the dysfunction of platelets, the primary mechanisms that underpin platelet-associated (...) complications during inflammatory diseases are not fully established. Here, we report the discovery of formyl peptide receptor 2, FPR2/ALX, in platelets and its primary role in the development of platelet-associated complications via ligation with its ligand, LL37. LL37 acts as a powerful endogenous antimicrobial peptide, but it also regulates innate immune responses. We demonstrate the impact of LL37 in the modulation of platelet reactivity, hemostasis, and thrombosis. LL37 activates a range of platelet

2018 Blood advances

80. A review of antibiotic prophylaxis for traveler’s diarrhea: past to present Full Text available with Trip Pro

A review of antibiotic prophylaxis for traveler’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

2018 Tropical diseases, travel medicine and vaccines