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Latest & greatest articles for antibiotics
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Antibiotics also referred to as antibacterial are a type of medicine that prevents the growth of bacteria. As such they are used to treat infections caused by bacteria. They kill or prevents bacteria from spreading.
Antibiotics are vital in modern day medicine; they are among the most frequently prescribed drug. There are over a 100 types of antibiotics, the main types and most commonly prescribed are penicillin, cephalosporin, macrolides, fluoroquinolone and tetracycline. They tend to be classified by mechanism of action. So, those that target the bacterial cell wall (penicillins and cephalosporins) or the cell membrane (polymyxins), or interfere with essential bacterial enzymes (rifamycins, lipiarmycins, quinolones, and sulfonamides) have bactericidal activities. Antibiotics such as macrolides, lincosamides and tetracyclines inhibit protein synthesis.
Antibiotics can all be defined by their specificity. “Narrow-spectrum” antibiotics target specific types of bacteria, for instance gram-negative (-ve) or gram-positive (+ve), whereas broad-spectrum antibiotics affect a wide range of bacteria.
Antibiotics are increasingly suffering from antibiotic resistance caused by bacterial mutations meaning the bacteria evolves to not be sensitive to the specific antibiotics being used.
Clinical trials are important to the development and understanding of antibiotics and their side effects. Although they are deemed safe, over use of the drug can kill good bacteria and lead to antibiotic resistance. This halts the ability of bacteria and microorganisms to resist the effects of the antibiotic. Clinical trials and research allow scientists and medical professionals to study the effects and develop new antibiotics.
The clinical effectiveness and cost effectiveness of antibiotic regimens for pelvic inflammatory disease The clinical effectiveness and cost effectiveness of antibiotic regimens for pelvic inflammatory disease The clinical effectiveness and cost effectiveness of antibiotic regimens for pelvic inflammatory disease Meads C, Knight T, Hyde C, Wilson J Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been (...) made for the HTA database. Citation Meads C, Knight T, Hyde C, Wilson J. The clinical effectiveness and cost effectiveness of antibiotic regimens for pelvic inflammatory disease. Birmingham: West Midlands Health Technology Assessment Collaboration (WMHTAC). DPHE Report No. 45. 2004 Authors' objectives This systematic review investigated the clinical effectiveness and cost-effectiveness of antibiotic treatments for pelvic inflammatory disease, particularly in relation to the seven currently
Effectiveness of antimicrobial adjuncts to scaling and root planing therapy for periodontitis Effectiveness of antimicrobial adjuncts to scaling and root planing therapy for periodontitis Effectiveness of antimicrobial adjuncts to scaling and root planing therapy for periodontitis Bonito AJ, Lohr KN, Lux L, Sutton S, Jackman A, Whitener L, Evensen C Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality (...) of this assessment has been made for the HTA database. Citation Bonito AJ, Lohr KN, Lux L, Sutton S, Jackman A, Whitener L, Evensen C. Effectiveness of antimicrobial adjuncts to scaling and root planing therapy for periodontitis. Rockville: Agency for Healthcare Research and Quality (AHRQ). Evidence Report/Technology Assessment No. 88. 2004 Authors' objectives The key question is whether scaling and root planing (SRP) accompanied by an antimicrobial agent, as a supplemental or adjunct treatment, results
A systematic review of the effectiveness of antimicrobial rinse-free hand sanitizers for prevention of illness-related absenteeism in elementary school children Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Antibiotic prophylaxis in elective laparoscopic cholecystectomy: lack of need or lack of evidence? Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
, the adjusted relative risk of antibiotic exposure was 0.49 (95% CI 0.44-0.55; p<0.0001) compared with the standard group. Antibiotic use was significantly reduced in all diagnostic subgroups. Clinical and laboratory outcome was similar in both groups and favourable in 235 (97%).Procalcitonin guidance substantially reduced antibiotic use in lower respiratory tract infections. Withholding antimicrobial treatment did not compromise outcome. In view of the current overuse of antimicrobial therapy in often self (...) Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: cluster-randomised, single-blinded intervention trial. Lower respiratory tract infections are often treated with antibiotics without evidence of clinically relevant bacterial disease. Serum calcitonin precursor concentrations, including procalcitonin, are raised in bacterial infections. We aimed to assess a procalcitonin-based therapeutic strategy to reduce antibiotic use in lower
2004LancetControlled trial quality: predicted high
Monthly antibiotic chemoprophylaxis and incidence of sexually transmitted infections and HIV-1 infection in Kenyan sex workers: a randomized controlled trial. Sexually transmitted infections (STIs) are common in female sex workers (FSWs) and may enhance susceptibility to infection with human immunodeficiency virus type 1 (HIV-1).To examine regular antibiotic prophylaxis in FSWs as a strategy for reducing the incidence of bacterial STIs and HIV-1.Randomized, double-blind, placebo-controlled
Effect of lactobacillus in preventing post-antibiotic vulvovaginal candidiasis: a randomised controlled trial. To test whether oral or vaginal lactobacillus can prevent vulvovaginitis after antibiotic treatment.Randomised, placebo controlled, double blind, factorial 2x2 trial.Fifty general practices and 16 pharmacies in Melbourne, Australia.Non-pregnant women aged 18-50 years who required a short course of oral antibiotics for a non-gynaecological infection: 278 were enrolled in the study (...) , and results were available for 235.Lactobacillus preparations taken orally or vaginally, or both, from enrollment until four days after completion of their antibiotic course.Participants' reports of symptoms of post-antibiotic vulvovaginitis, with microbiological evidence of candidiasis provided by a self obtained vaginal swab.Overall, 55/235 (23% (95% confidence interval 18% to 29%)) women developed post-antibiotic vulvovaginitis. Compared with placebo, the odds ratio for developing post-antibiotic
Antibiotics or surgery for vesicoureteric reflux in children. 1-2% of children have vesicoureteric reflux (VUR). VUR occurs in 25-40% of children with acute pyelonephritis. VUR can lead to renal scarring, hypertension, and end-stage renal disease. The best form of treatment for children with VUR is debated: no treatment, long-term antibiotic prophylaxis, surgery, or a combination of antibiotic prophylaxis and surgery. In children with recurrent urinary tract infections (UTIs) and progressive (...) renal damage, despite antibiotic prophylaxis, surgical correction of VUR, especially high-grade VUR, is generally recommended.Danielle Wheeler and colleagues recently did a meta-analysis of ten randomised controlled trials (964 children) to evaluate whether any intervention for VUR is better than no treatment (Cochrane Database Syst Rev 2004; 3: CD001532). The main endpoints were incidence of UTIs, new or progressive renal damage, renal growth, hypertension, and glomerular filtration rate
Absence of cross-reactivity between sulfonamide antibiotics and sulfonamide nonantibiotics. The safety of sulfonamide nonantibiotics is unclear in patients with prior allergic reactions to sulfonamide antibiotics.We conducted a retrospective cohort study using the General Practice Research Database in the United Kingdom, examining the risk of allergic reactions within 30 days after the receipt of a sulfonamide nonantibiotic. Patients with evidence of prior hypersensitivity after the receipt (...) of a sulfonamide antibiotic were compared with those without such evidence. Similar analyses were also performed with the use of penicillins instead of sulfonamides, to determine whether any risk was specific to sulfonamide cross-reactivity.Of 969 patients with an allergic reaction after a sulfonamide antibiotic, 96 (9.9 percent) had an allergic reaction after subsequently receiving a sulfonamide nonantibiotic. Of 19,257 who had no allergic reaction after a sulfonamide antibiotic, 315 (1.6 percent) had
The relationship among previous antimicrobial use, antimicrobial resistance, and treatment outcomes for Helicobacter pylori infections. The relationship between previous antimicrobial treatments and infection with drug-resistant Helicobacter pylori is unknown.To determine whether previous use of antimicrobial agents predicts subsequent antibiotic resistance of H. pylori and whether resistance affects treatment outcome.Retrospective cohort analysis of adults recruited sequentially from (...) a clinical practice.A referral hospital in Anchorage, Alaska.125 adults infected with H. pylori.Medical records were reviewed for antimicrobial agents prescribed in the 10 years before diagnosis with H. pylori infection. Antimicrobial susceptibility of H. pylori isolates obtained from endoscopic gastric biopsy was determined by using agar dilution. Cure was determined by using the urea breath test 2 months after antimicrobial treatment.Among the 125 patients, 37 (30%) were found to have H. pylori
Long-term persistence of resistant Enterococcus species after antibiotics to eradicate Helicobacter pylori. Antibiotic treatment selects for resistance not only in the pathogen to which it is directed but also in the indigenous microflora.To determine whether a widely used regimen (clarithromycin, metronidazole, and omeprazole) for Helicobacter pylori eradication affects resistance development in enterococci.Cohort study.Endoscopy units at 3 community hospitals in Sweden.5 consecutive dyspeptic (...) patients who were colonized with H. pylori, had endoscopy-confirmed duodenal ulcer, and received antibiotic treatment, and 5 consecutive controls with dyspepsia but no ulcer who did not receive treatment.Fecal samples were obtained from patients and controls before, immediately after, 1 year after, and 3 years after treatment. From each patient and sample, enterococci were isolated and analyzed for DNA fingerprint, clarithromycin susceptibility, and presence of the erm(B) gene.In treated patients, all
Changing use of antibiotics in community-based outpatient practice, 1991-1999. Judicious use of antibiotics can slow the spread of antimicrobial resistance. However, overall patterns of antibiotic use among ambulatory patients are not well understood.To study patterns of outpatient antibiotic use in the United States, focusing on broad-spectrum antibiotics.Cross-sectional survey in three 2-year periods (1991-1992, 1994-1995, and 1998-1999).The National Ambulatory Medical Care Survey (...) , a nationally representative sample of community-based outpatient visits.Patients visiting community-based outpatient clinics.Rates of overall antibiotic use and use of broad-spectrum antibiotics (azithromycin and clarithromycin, quinolones, amoxicillin-clavulanate, and second- and third-generation cephalosporins). All comparisons were made between the first study period (1991-1992) and the final study period (1998-1999).Between 1991-1992 and 1998-1999, antibiotics were used less frequently to treat acute
Antibiotic resistance among gram-negative bacilli in US intensive care units: implications for fluoroquinolone use. Previous surveillance studies have documented increasing rates of antimicrobial resistance in US intensive care units (ICUs) in the early 1990s.To assess national rates of antimicrobial resistance among gram-negative aerobic isolates recovered from ICU patients and to compare these rates to antimicrobial use.Participating institutions, representing a total of 43 US states plus (...) the District of Columbia, provided antibiotic susceptibility results for 35 790 nonduplicate gram-negative aerobic isolates recovered from ICU patients between 1994 and 2000.Each institution tested approximately 100 consecutive gram-negative aerobic isolates recovered from ICU patients. Organisms were identified to the species level. Susceptibility tests were performed, and national fluoroquinolone consumption data were obtained.The activity of most antimicrobial agents against gram-negative aerobic
Predictors of broad-spectrum antibiotic prescribing for acute respiratory tract infections in adult primary care. Broad-spectrum antibiotics are commonly prescribed, but little is known about the physicians who prescribe and the patients who take these agents.To identify factors associated with prescribing of broad-spectrum antibiotics by physicians caring for patients with nonpneumonic acute respiratory tract infections (ARTIs).Cross-sectional study using data from the National Ambulatory (...) Medical Care Survey between 1997 and 1999. Information was collected on a national sample of 1981 adults seen by physicians for the common cold and nonspecific upper respiratory tract infections (URTIs) (24%), acute sinusitis (24%), acute bronchitis (23%), otitis media (5%), pharyngitis, laryngitis, and tracheitis (11%), or more than 1 of the above diagnoses (13%).Prescription of broad-spectrum antibiotics, defined for this study as quinolones, amoxicillin/clavulanate, second- and third-generation
Linezolid: the first oxazolidinone antimicrobial. Linezolid is the first of a new class of antimicrobial agents, the oxazolidinones, to be approved for clinical use in the United States and elsewhere. The drug is a totally synthetic compound, which lessens the likelihood of naturally occurring resistance mechanisms. It has excellent activity against virtually all important gram-positive pathogens, including methicillin-resistant staphylococci, penicillin-resistant pneumococci, macrolide
Why do general practitioners prescribe antibiotics for sore throat? Grounded theory interview study. To understand why general practitioners prescribe antibiotics for some cases of sore throat and to explore the factors that influence their prescribing.Grounded theory interview study.General practice.40 general practitioners: 25 in the maximum variety sample and 15 in the theoretical sample.General practitioners are uncertain which patients will benefit from antibiotics but prescribe for sicker
Prophylactic antibiotics for preventing early central venous catheter Gram positive infections in oncology patients. Long-term tunnelled central venous catheters (TCVC) are increasingly used in oncology patients. Despite guidelines on insertion, maintenance and use, infections remain an important complication. Most infections are caused by Gram-positive bacteria. Therefore antimicrobial prevention strategies aimed at these micro-organisms could potentially decrease the majority of the TCVC (...) infections.To determine the efficacy of administering antibiotics prior to insertion of a TCVC with or without vancomycin/heparin flush technique in the first 45 days after insertion of the catheter to prevent Gram-positive catheter-related infections in oncology patients.We searched MEDLINE, EMBASE,and CENTRAL up to July 2001. Reference lists from relevant articles were scanned and conference proceedings were hand searched. The authors of eligible studies were contacted to obtain additional information.We
Antibiotics to prevent complications following dental implant treatment. Some dental implant failures may be due to bacterial contamination at implant insertion. Infections around biomaterials are difficult to treat and almost all infected implants have to be removed. In general, antibiotic prophylaxis in surgery is only indicated for patients at risk of infectious endocarditis, for patients with reduced host-response, when surgery is performed in infected sites, in cases of extensive (...) and prolonged surgical interventions and when large foreign materials are implanted. To minimise infections after dental implant placement various prophylactic systemic antibiotic regimens have been suggested. More recent protocols recommended short term prophylaxis, if antibiotics have to be used. With the administration of antibiotics adverse events may occur, ranging from diarrhoea to life-threatening allergic reactions. Another major concern associated with the widespread use of antibiotics
debridement, may be prevented by administering systemic antibiotics to 'sterilise' tissues adjacent to necrotic areas. There are theoretical risks of encouraging antibacterial resistance and opportunistic fungal infections.To determine the effectiveness and safety of prophylactic antibiotic therapy in patients with severe acute pancreatitis who have developed pancreatic necrosis.MEDLINE, EMBASE, and the Cochrane Library were searched. We also examined other sources including Conference Abstracts (...) Antibiotic therapy for prophylaxis against infection of pancreatic necrosis in acute pancreatitis. Acute pancreatitis is a common acute abdominal emergency which lacks specific therapy. In severe attacks, areas of the pancreas may become necrotic. The mortality risk rises to >40% if sterile necrosis becomes superinfected, usually with gut derived aerobic organisms. Experimental and clinical studies indicate a window of opportunity of 1-2 weeks, when superinfection, and thus high-risk surgical
Antimicrobial drugs for treating methicillin-resistant Staphylococcus aureus colonization. Eradication strategies for methicillin-resistant Staphylococcus aureus (MRSA) are variable. We sought to summarize the evidence for use of antimicrobial agents to eradicate MRSA.To describe the effects of topical and systemic antimicrobial agents on nasal and extra-nasal MRSA carriage, adverse events, and incidence of subsequent MRSA infections.We searched the Cochrane Infectious Diseases Group's trials (...) register (August 2003), the Cochrane Central Register of Controlled Trials (Issue 3, 2003), MEDLINE (1966 to 2003), EMBASE (1988 to 2003), handsearched relevant literature, and contacted MRSA experts and the manufacturer of mupirocin.Randomized controlled trials of patients colonized with MRSA comparing topical or systemic antimicrobials to placebo or no treatment, and trials comparing various combinations of topical or systemic agents to no treatment, placebo, or to topical or systemic agents.Two