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

101. Antimicrobial resistance (AMR): applying All Our Health

prevent ill health and promote wellbeing as part of their everyday practice. The information below will help front-line health and care staff use their trusted relationships with patients, families and communities to promote the benefits of preventing antimicrobial resistance ( of ‘All Our Health’ topics. Infections that cannot be treated continue to develop. The rapid spread of multidrug resistant organisms means that we may not be able to treat everyday infections or diseases with antibiotics (...) in the near future. Many existing antimicrobials are becoming less effective as bacteria, viruses, protozoa and fungi are adapting and becoming resistant to medicines. Inappropriate use of these valuable medicines has also added to the problem. Without effective antibiotics, even minor surgery and routine operations could become high risk procedures if serious infections can’t be treated. Access the antimicrobial resistance e-learning session An is now available to use. and 5 Year Action Plan set out

2019 Public Health England

102. Antibiotic use for irreversible pulpitis. (Abstract)

Antibiotic use for irreversible pulpitis. Irreversible pulpitis, which is characterised by acute and intense pain, is one of the most frequent reasons that patients attend for emergency dental care. Apart from removal of the tooth, the customary way of relieving the pain of irreversible pulpitis is by drilling into the tooth, removing the inflamed pulp (nerve) and cleaning the root canal. However, a significant number of dentists continue to prescribe antibiotics to stop the pain (...) of irreversible pulpitis.This review updates the previous version published in 2016.To assess the effects of systemic antibiotics for irreversible pulpitis.We searched Cochrane Oral Health's Trials Register (to 18 February 2019); the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 1) in the Cochrane Library (searched 18 February 2019); MEDLINE Ovid (1946 to 18 February 2019); Embase Ovid (1980 to 18 February 2019); US National Institutes of Health Ongoing Trials Register

2019 Cochrane

103. Antibiotic therapy for adults with neurosyphilis. (Abstract)

Antibiotic therapy for adults with neurosyphilis. Neurosyphilis is an infection of the central nervous system, caused by Treponema pallidum, a spirochete capable of infecting almost any organ or tissue in the body causing neurological complications due to the infection. This disease is a tertiary manifestation of syphilis. The first-line treatment for neurosyphilis is aqueous crystalline penicillin. However, in cases such as penicillin allergy, other regimes of antibiotic therapy can be used.To (...) assess the clinical effectiveness and safety of antibiotic therapy for adults with neurosyphilis.We searched the Cochrane Library, CENTRAL, MEDLINE, Embase, LILACS, World Health Organization International Clinical Trials Registry Platform and Opengrey up to April 2019. We also searched proceedings of eight congresses to a maximum of 10 years, and we contacted trial authors for additional information.We included randomised clinical trials that included men and women, regardless of age, with definitive

2019 Cochrane

104. Head-to-head oral prophylactic antibiotic therapy for chronic obstructive pulmonary disease. (Abstract)

Head-to-head oral prophylactic antibiotic therapy for chronic obstructive pulmonary disease. Chronic obstructive pulmonary disease (COPD; including chronic bronchitis and emphysema) is a chronic respiratory condition characterised by shortness of breath, cough and recurrent exacerbations. Long-term antibiotic use may reduce both bacterial load and inflammation in the airways. Studies have shown a reduction of exacerbations with antibiotics in comparison to placebo in people with COPD (...) , but there are concerns about antibiotic resistance and safety.To compare the safety and efficacy of different classes of antibiotics (continuous, intermittent or pulsed) for prophylaxis of exacerbations in patients with COPD.We searched the Cochrane Airways Group Trials Register and bibliographies of relevant studies. The latest literature search was conducted on 6 February 2019.Randomised controlled trials (RCTs) were selected that compared one prophylactic antibiotic with another in patients with COPD.We used

2019 Cochrane

105. Two weeks versus four weeks of antibiotic therapy after surgical drainage for native joint bacterial arthritis: a prospective, randomised, non-inferiority trial Full Text available with Trip Pro

Two weeks versus four weeks of antibiotic therapy after surgical drainage for native joint bacterial arthritis: a prospective, randomised, non-inferiority trial The optimal duration of postsurgical antibiotic therapy for adult native joint bacterial arthritis remains unknown.We conducted a prospective, unblinded, randomised, non-inferiority study comparing either 2 or 4 weeks of antibiotic therapy after surgical drainage of native joint bacterial arthritis in adults. Excluded were implant (...) -related infections, episodes without surgical lavage and episodes with a follow-up of less than 2 months.We enrolled 154 cases: 77 in the 4-week arm and 77 in the 2-week arm. Median length of intravenous antibiotic treatment was 1 and 2 days, respectively. The median number of surgical lavages was 1 in both arms. Recurrence of infection was noted in three patients (2%): 1 in the 2-week arm (99% cure rate) and 2 in the 4-week arm (97% cure rate). There was no difference in the number of adverse events

2019 EvidenceUpdates

106. HTA of C-reactive protein point-of-care testing to guide antibiotic prescribing

a range of health services, in conjunction with the Department of Health and the HSE. Health Technology Assessment (HTA) of CRP POCT Health Information and Quality Authority iv Foreword Antimicrobial resistance occurs when bacteria adapt in response to the use of medicines. When bacteria become antibiotic resistant, infections become more difficult to manage and treat. Antimicrobial resistance is a significant threat to public health, and widely acknowledged to be associated with the excessive (...) , but not for those with acute bronchitis. ? Overprescribing of antibiotics for RTIs in primary care is common in most industrialised countries, with high levels of inappropriate prescribing documented. Antibiotic treatment of RTIs can expose patients to an increased risk of an adverse event, with one out of five patients experiencing mostly minor and self-limiting adverse events. Antimicrobial resistance (AMR) is a growing and significant threat to public health, and it is widely recognised that antibiotic

2019 Health Information and Quality Authority

107. The Collaborative Assessment, OTCA12, on “C-reactive protein point-of-care testing (CRP POCT) to guide antibiotic prescribing in primary care settings for acute respiratory tract infections (RTIs)

-reactive protein point-of-care testing to guide antibiotic prescribing for acute respiratory tract infections in primary care EUnetHTA Joint Action 3 WP4 3 Consultation of the draft Rapid Assessment External experts [V.1.3] Elizabeth Beech, National Project Lead – Healthcare Acquired Infection and Antimicrobial Resistance, NHS Improvement, England Dr Nuala O’Connor, Irish College of General Practitioners (ICGP) GP Lead HSE Clinical Programme HCAI-AMR Professor Martin Cormican, National Clinical Lead (...) ) RECOMMENDATIONS IN EUROPEAN COUNTRIES FOR CRP POCT 248 Figures FIGURE 1: ANATOMY OF THE RESPIRATORY TRACT 67 FIGURE 2: ANTIMICROBIAL RESISTANCE (COMBINED NON-SUSCEPTIBILITY FOR PENICILLINS AND MACROLIDES) VERSUS STREPTOCOCCUS PNEUMONIAE IN EU/EEA COUNTRIES, 2017 68 FIGURE 3: CONSUMPTION OF ANTIBIOTICS FOR SYSTEMIC USE IN THE COMMUNITY, EU/EEA COUNTRIES, 2016 (EXPRESSED AS DDD PER 1 000 INHABITANTS PER DAY) 69 FIGURE 4: FLOW CHART SYSTEMATIC REVIEW 1 (EFFECTIVENESS AND SAFETY) 83 C-reactive protein point

2019 EUnetHTA

108. Fluoroquinolone antibiotics: new restrictions and precautions for use due to very rare reports of disabling and potentially long-lasting or irreversible side effects

and tendon rupture report suspected adverse drug reactions to fluoroquinolone antibiotics on the or via the Yellow Card app (download it from the , or ) New restricted indications Fluoroquinolones are antibiotics authorised for serious, life-threatening bacterial infections. As for all antibiotic medicines, consideration should be given to official guidance on the appropriate use of antibacterial agents (see section below on Prescribing guidance). Following an EU-wide review of safety, new restricted (...) Fluoroquinolone antibiotics: new restrictions and precautions for use due to very rare reports of disabling and potentially long-lasting or irreversible side effects Fluoroquinolone antibiotics: new restrictions and precautions for use due to very rare reports of disabling and potentially long-lasting or irreversible side effects - GOV.UK GOV.UK uses cookies to make the site simpler. or Search Fluoroquinolone antibiotics: new restrictions and precautions for use due to very rare reports

2019 MHRA Drug Safety Update

109. Proposals for a more effective antibiotic policy in Belgium

(BAPCOC) 24 1.1.6 Difficult to obtain significant improvements 24 1.2 RESEARCH QUESTIONS & SCOPE 25 1.3 TERMINOLOGY 25 1.4 METHODOLOGY 26 1.5 STRUCTURE OF THE REPORT 26 2 ANTIBIOTIC USE AND ITS LINK WITH ANTIBACTERIAL RESISTANCE 27 2.1 WHAT IS ANTIMICROBIAL RESISTANCE? 27 2.1.1 Antibacterial resistance, a natural phenomenon 27 2.1.2 How do bacteria become resistant? 27 2.1.3 How does antibiotic resistance spread? 28 2.1.4 Multidrug resistant organisms 28 2.1.1 Resistance in community and healthcare (...) . This document is available on the website of the Belgian Health Care Knowledge Centre. KCE Report 311 Antibiotic policy in Belgium 1 ? TABLE OF CONTENTS LIST OF FIGURES 8 LIST OF TABLES 10 LIST OF ABBREVIATIONS 13 ? SCIENTIFIC REPORT 23 1 INTRODUCTION 23 1.1 SHORT DESCRIPTION OF THE PROBLEM 23 1.1.1 Antibiotic resistance 23 1.1.2 Antibiotic use in Belgium 24 1.1.3 The concept of prudent antimicrobial/antibiotic use 24 1.1.4 One Health approach 24 1.1.5 Belgian Antibiotic Policy Coordination Committee

2019 Belgian Health Care Knowledge Centre

110. Effect of prolonged antibiotic treatment on cognition in patients with Lyme borreliosis Full Text available with Trip Pro

Effect of prolonged antibiotic treatment on cognition in patients with Lyme borreliosis To investigate whether longer-term antibiotic treatment improves cognitive performance in patients with persistent symptoms attributed to Lyme borreliosis.Data were collected during the Persistent Lyme Empiric Antibiotic Study Europe (PLEASE) trial, a randomized, placebo-controlled study. Study participants passed performance-validity testing (measure for detecting suboptimal effort) and had persistent (...) treatment with ceftriaxone followed by a 12-week regimen of doxycycline or clarithromycin/hydroxychloroquine did not lead to better cognitive performance compared to a 2-week regimen of ceftriaxone in patients with Lyme disease-attributed persistent symptoms.NCT01207739.This study provides Class II evidence that longer-term antibiotics in patients with borreliosis-attributed persistent symptoms does not increase cognitive performance compared to shorter-term antibiotics.Copyright © 2019 The Author(s

2019 EvidenceUpdates

111. 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

112. 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

113. 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

114. 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

115. 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

116. 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

117. 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

118. 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

119. 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

120. 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