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

1321. Efficacy of prophylactic antibiotic therapy in spinal surgery: a meta-analysis

Efficacy of prophylactic antibiotic therapy in spinal surgery: a meta-analysis Efficacy of prophylactic antibiotic therapy in spinal surgery: a meta-analysis Efficacy of prophylactic antibiotic therapy in spinal surgery: a meta-analysis Barker F G Authors' objectives To examine the efficacy of prophylactic antibiotic treatment in spinal surgery. Searching A primary search was undertaken in MEDLINE (1966 to October 2000); further details, including search terms, were reported. Additional (...) searches were undertaken in MEDLINE and the Cochrane Controlled Trials Register. The reference lists of textbook chapters, review articles, and the articles retrieved from the primary search were also examined. Study selection Study designs of evaluations included in the review The inclusion criteria specified that randomised controlled trials (RCTs) were eligible. Data from non-randomised trials were also reported. Specific interventions included in the review Comparisons of prophylactic antibiotic

2002 DARE.

1322. Antibiotic treatment of acute bronchitis in smokers: a systematic review

Antibiotic treatment of acute bronchitis in smokers: a systematic review Antibiotic treatment of acute bronchitis in smokers: a systematic review Antibiotic treatment of acute bronchitis in smokers: a systematic review Linder J A, Sim I Authors' objectives To determine the efficacy of antibiotics for smokers with acute bronchitis. Searching MEDLINE was searched from January 1966 to September 2001 for English language articles. The search terms were reported. The references of retrieved articles (...) were checked for additional studies. Study selection Study designs of evaluations included in the review Randomised placebo-controlled trials were eligible. Specific interventions included in the review Studies of antibiotics were eligible. The antibiotics examined in the included trials were doxycycline, trimethoprim-sulfamethoxazole (TMP-SMX) and erythromycin. Participants included in the review Studies of adults with acute bronchitis, both smokers and nonsmokers, who were previously healthy

2002 DARE.

1323. Effect of changes in antibiotic prescribing on patient outcomes in a community setting: a natural experiment in Australia Full Text available with Trip Pro

Effect of changes in antibiotic prescribing on patient outcomes in a community setting: a natural experiment in Australia Effect of changes in antibiotic prescribing on patient outcomes in a community setting: a natural experiment in Australia Effect of changes in antibiotic prescribing on patient outcomes in a community setting: a natural experiment in Australia Beilby J, Marley J, Walker D, Chamberlain N, Burke M Record Status This is a critical abstract of an economic evaluation that meets (...) the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The prescription of antibiotics in a community setting, before and after an Australian government directive, was under evaluation. Type of intervention Other: Policy (prescribing behaviour). Economic study type Cost-effectiveness analysis. Study population The study

2002 NHS Economic Evaluation Database.

1324. Reducing antibiotic use for acute bronchitis in primary care: blinded, randomised controlled trial of patient information leaflet. Full Text available with Trip Pro

Reducing antibiotic use for acute bronchitis in primary care: blinded, randomised controlled trial of patient information leaflet. To assess whether sharing the uncertainty of the value of antibiotics for acute bronchitis in the form of written and verbal advice affects the likelihood of patients taking antibiotics.Nested, single blind, randomised controlled trial.Three suburban general practices in Nottingham Participants: 259 previously well adults presenting with acute bronchitis.In group (...) A, 212 patients were judged by their general practitioner not to need antibiotics that day but were given a prescription to use if they got worse and standard verbal reassurance. Half of them (106) were also given an information leaflet. All patients in group B (47) were judged to need antibiotics and were given a prescription and encouraged to use it.Antibiotic use in the next two weeks. Reconsultation for the same symptoms in the next month.In group A fewer patients who received the information

2002 BMJ Controlled trial quality: predicted high

1325. Antibiotic therapy for acute appendicitis: Ampicillin, metronidazole plus gentamycin versus cephalosporin

Antibiotic therapy for acute appendicitis: Ampicillin, metronidazole plus gentamycin versus cephalosporin Antibiotic therapy for acute appendicitis: Ampicillin, metronidazole plus gentamycin versus cephalosporin Antibiotic therapy for acute appendicitis: Ampicillin, metronidazole plus gentamycin versus cephalosporin Muggli E 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 Muggli E. Antibiotic therapy for acute appendicitis: Ampicillin, metronidazole plus gentamycin versus cephalosporin. Clayton, Victoria: Centre for Clinical Effectiveness (CCE) 2002: 12 Authors' objectives This aim of this report was to assess which antibiotic regimen is more appropriate for acute appendicitis: Ampicillin, metronidazole plus gentamycin or cephalosporin (+/- metronidazole). Authors' conclusions - One randomised trial was reviewed that met inclusion and exclusion criteria

2002 Health Technology Assessment (HTA) Database.

1326. Bolus versus continuous infusion of antibiotics in paediatric patients and its effect on intravenous access patency

Bolus versus continuous infusion of antibiotics in paediatric patients and its effect on intravenous access patency Bolus versus continuous infusion of antibiotics in paediatric patients and its effect on intravenous access patency Bolus versus continuous infusion of antibiotics in paediatric patients and its effect on intravenous access patency Jackson N 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 Jackson N. Bolus versus continuous infusion of antibiotics in paediatric patients and its effect on intravenous access patency. Clayton, Victoria: Centre for Clinical Effectiveness (CCE) 2002: 7 Authors' objectives This aim of this report was to assess the effectiveness of bolus versus continuous infusion of antibiotics in paediatric patients and its effect on intravenous access patency. Authors' conclusions - No studies were identified that directly

2002 Health Technology Assessment (HTA) Database.

1327. Predictors of poor outcome and benefits from antibiotics in children with acute otitis media: pragmatic randomised trial. Full Text available with Trip Pro

Predictors of poor outcome and benefits from antibiotics in children with acute otitis media: pragmatic randomised trial. To identify which children with acute otitis media are at risk of poor outcome and to assess benefit from antibiotics in these children.Secondary analysis of randomised controlled trial cohort.Primary care.315 children aged 6 months to 10 years.Immediate or delayed (taken after 72 hours if necessary) antibiotics.Predictors of short term outcome: an episode of distress (...) was less likely with immediate antibiotics (32% for immediate v 53% for delayed, chi2=4.0; P=0.045, number needed to treat 5) as was night disturbance (26% v 59%, chi2=9.3; P=0.002; number needed to treat 3). In children without higher temperature or vomiting, immediate antibiotics made little difference to distress by day three (15% v 19%, chi2=0.74; P=0.39) or night disturbance (20% v 27%, chi2=1.6; P=0.20). Addition of cough did not significantly improve prediction of benefit.In children with otitis

2002 BMJ Controlled trial quality: predicted high

1328. Antimicrobial treatment in diabetic women with asymptomatic bacteriuria. (Abstract)

Antimicrobial treatment in diabetic women with asymptomatic bacteriuria. Asymptomatic bacteriuria is common among women with diabetes, and the treatment of such infections has been recommended to prevent complications related to symptomatic urinary tract infection.We enrolled women (>16 years of age) with diabetes, bacteriuria (> or =105 colony-forming units of an organism per milliliter in cultures of two consecutive urine specimens), and no urinary symptoms; 50 were randomly assigned (...) to receive placebo and 55 to receive antimicrobial therapy. For the first six weeks, which included the initial course of treatment, the study was placebo-controlled and double-blind. Subsequently, the women were screened for bacteriuria every three months for up to three years; antimicrobial therapy was provided to women in the antimicrobial-therapy group who had asymptomatic bacteriuria.Four weeks after the end of the initial course of therapy, 78 percent of placebo recipients had bacteriuria

2002 NEJM Controlled trial quality: predicted high

1329. Oxazolidinone antibiotics. (Abstract)

Oxazolidinone antibiotics. Many common gram-positive pathogens (eg, Staphylococcus aureus, Enterococcus spp, and Streptococcus pneumoniae) have become increasingly resistant to antimicrobial agents, and new drugs with activity against gram-positive bacteria are urgently needed. The oxazolidinones, a new chemical class of synthetic antimicrobial agent, have a unique mechanism of inhibiting bacterial protein synthesis. Linezolid, the first oxazolidinone to be approved for clinical use, displays

2001 Lancet

1330. Antibacterial prescribing and antibacterial resistance in English general practice: cross sectional study. Full Text available with Trip Pro

Antibacterial prescribing and antibacterial resistance in English general practice: cross sectional study. To quantify the relation between community based antibacterial prescribing and antibacterial resistance in community acquired disease.Cross sectional study of antibacterial prescribing and antibacterial resistance of routine isolates within individual practices and primary care groups.405 general practices (38 groups) in south west and north west England.Correlation between antibacterial (...) and amoxicillin than average would have about 1% fewer resistant isolates (0.94/100; 95% confidence interval 0.02 to 1.85). Resistance of S pneumoniae to both penicillin and erythromycin remains uncommon, and no clear relation with prescribing was found.Routine microbiological isolates should not be used for surveillance of antibacterial resistance in the community or for monitoring the outcome of any change in antibacterial prescribing by general practitioners. Trying to reduce the overall level

2001 BMJ

1331. The isolation of antibiotic-resistant salmonella from retail ground meats. Full Text available with Trip Pro

The isolation of antibiotic-resistant salmonella from retail ground meats. Salmonella is a leading cause of foodborne illness. The emergence of antimicrobial-resistant salmonella is associated with the use of antibiotics in animals raised for food; resistant bacteria can be transmitted to humans through foods, particularly those of animal origin. We identified and characterized strains of salmonella isolated from ground meats purchased in the Washington, D.C., area.Salmonella was isolated from (...) samples of ground chicken, beef, turkey, and pork purchased at three supermarkets. The isolates were characterized by serotyping, antimicrobial-susceptibility testing, phage typing, and pulsed-field gel electrophoresis. The polymerase chain reaction and DNA sequencing were used to identify resistance integrons and extended spectrum beta-lactamase genes.Of 200 meat samples, 41 (20 percent) contained salmonella, with a total of 13 serotypes. Eighty-four percent of the isolates were resistant to at least

2001 NEJM

1332. Impact of first-line vs second-line antibiotics for the treatment of acute uncomplicated sinusitis. (Abstract)

Impact of first-line vs second-line antibiotics for the treatment of acute uncomplicated sinusitis. Studies suggest little benefit in relief of acute sinusitis symptoms from the use of newer and more expensive (second-line) antibiotics instead of older and less expensive (first-line) antibiotics. However, researchers have failed to include development of complications and cost of care in their analyses.To compare the effectiveness and cost of first-line with second-line antibiotics (...) for the treatment of acute uncomplicated sinusitis in adults.Retrospective cohort study using a pharmaceutical database containing demographic, clinical (International Classification of Diseases, Ninth Revision), treatment, and charge information for 29 102 adults with a diagnosis of acute sinusitis receiving initial antibiotic treatment between July 1, 1996, and June 30, 1997.Absence of additional claim for an antibiotic in the 28 days after the initial antibiotic, presence of a claim for a second antibiotic

2001 JAMA

1333. Antibiotic treatment of adults with sore throat by community primary care physicians: a national survey, 1989-1999. (Abstract)

Antibiotic treatment of adults with sore throat by community primary care physicians: a national survey, 1989-1999. Most sore throats are due to viral upper respiratory tract infections. Group A beta-hemolytic streptococci (GABHS), the only common cause of sore throat warranting antibiotics, is cultured in 5% to 17% of adults with sore throat. The frequency of antibiotic use for pharyngitis has greatly exceeded the prevalence of GABHS, but less is known about specific classes of antibiotics (...) used. Only penicillin and erythromycin are recommended as first-line antibiotics against GABHS.To measure trends in antibiotic use for adults with sore throat and to determine predictors of antibiotic use and nonrecommended antibiotic use.Retrospective analysis of 2244 visits to primary care physicians in office-based practices in the National Ambulatory Medical Care Survey, 1989-1999, by adults with a chief complaint of sore throat.Treatment with antibiotics and treatment with nonrecommended

2001 JAMA

1334. Long-term antibiotics for preventing recurrent urinary tract infection in children. (Abstract)

Long-term antibiotics for preventing recurrent urinary tract infection in children. Acute urinary tract infection (UTI) is common in children. By the age of seven years, 8.4% of girls and 1.7% of boys will have suffered at least one episode. Symptoms are systemic rather than localised in early childhood and consist of fever, lethargy, anorexia, and vomiting. UTI is caused by E. coli in over 80% of cases and treatment consists of a course of antibiotics. Due to the unpleasant acute illness (...) caused by UTI and the risk of pyelonephritis-induced permanent kidney damage, many children are given long-term antibiotics aimed at preventing recurrence. However these medications may cause side effects and promote the development of resistant bacteria.To determine the efficacy and side effects of long-term antibiotics given to prevent recurrent UTI in children.A search of MEDLINE (1966 to Jan 2001), EMBASE (1988 to Jan 2001) and the Cochrane Controlled Trials Register for relevant randomised

2001 Cochrane

1335. Elective versus symptomatic intravenous antibiotic therapy for cystic fibrosis. (Abstract)

Elective versus symptomatic intravenous antibiotic therapy for cystic fibrosis. Pseudomonas aeruginosa is the commonest micro-organism associated with respiratory infections in cystic fibrosis. Retrospective studies have suggested that survival is increased by using an aggressive policy of intravenous antipseudomonal antibiotics at regular intervals, irrespective of symptoms.To determine whether there is evidence that an elective (regular) versus symptomatic intravenous antibiotic regime (...) is associated with an improvement in clinical status and survival rates in patients with cystic fibrosis. To identify any adverse effects associated with the use of elective intravenous antibiotics, including an increase in the development of resistant organisms.The Cochrane Cystic Fibrosis and Genetics Disorders Group Specialist Trials Register was used. This comprises references identified from comprehensive electronic database searches, hand searching relevant journals and abstracts from conference

2001 Cochrane

1336. Antibiotics for syphilis diagnosed during pregnancy. (Abstract)

Antibiotics for syphilis diagnosed during pregnancy. Congenital syphilis is an increasing problem in many developing countries and in the transitional economies of Eastern Europe and the former Soviet Union. In several countries this increase has been aggravated by HIV/AIDS. While the effectiveness of penicillin in the treatment of syphilis in pregnant women and the prevention of congenital syphilis was established shortly after the introduction of penicillin in the 1940s, there is uncertainty (...) about the optimal treatment regimens.To identify the most effective antibiotic treatment regimen (in terms of dose, length of course and mode of administration) of syphilis with and without concomitant infection with HIV for pregnant women infected with syphilis.MEDLINE 1966 to March 2000; EMBASE 1974 to March 2000, the Cochrane Controlled Trials Register (last searched March 2001), the Cochrane Pregnancy and Childbirth group trials register (last searched March 2001) and the references

2001 Cochrane

1337. Antibiotics for spontaneous bacterial peritonitis in cirrhotics. (Abstract)

Antibiotics for spontaneous bacterial peritonitis in cirrhotics. Spontaneous bacterial peritonitis is mainly a complication of cirrhotic ascites that occurs in the absence of any intra-abdominal, surgically treatable source of infection. Antibiotics have been recommended as the mainstay treatment for spontaneous bacterial peritonitis. However, this recommendation is not based on convincing evidence. It has been proposed that treatment should cover Gram-negative enteric bacteria and Gram (...) -positive cocci, that are responsible for up to 90% of cases.To evaluate the effectiveness and safety of different types and ways of antibiotic therapy for spontaneous bacterial peritonitis in cirrhotic patients.Electronic searches on the Cochrane Library (Issue 3, 2000), the Cochrane Hepato-Biliary Group Trials Register (March 2000), EMBASE (1980-2000), MEDLINE (1966-2000); scanning the references of all identified studies; contacting the first author of each included trial.Randomised trials comparing

2001 Cochrane

1338. Antibiotics for acute asthma. (Abstract)

Antibiotics for acute asthma. Antibiotics are often prescribed to patients who are admitted to hospital with acute asthma. Their exacerbation is often precipitated by a viral upper respiratory infection (URTI), but in some instances antibiotics are prescribed in spite of questionable efficacy. A lack of strong evidence either to support or to refute the use of treatments in acute asthma leaves room for discussion and debate as to how effective antibiotics are in an acute setting. This review (...) assesses what evidence is available.To determine the efficacy of antibiotics prescribed in the treatment of acute asthmaElectronic databases (MEDLINE, EMBASE and CINAHL) were searched to identify all possible randomised control trials.Only RCTs or quasi RCTs were eligible for inclusion. Studies were included if patients were treated for acute asthma in the ED or its equivalent with antibiotics or placebo. Two reviewers independently assessed articles for potential relevance, final inclusion

2001 Cochrane

1339. Antibiotics versus placebo for prevention of postoperative infection after appendicectomy. (Abstract)

that postoperative infections are reduced by administration of antimicrobial regimes.The objective of this review is to compare the use of antibiotics with placebo or no treatment in patients undergoing appendectomy. Will these patients benefit from antimicrobial prophylaxis? The outcomes are described according to the nature of the appendix, as either simple appendicitis (including the non-infectious stage) and complicated appendicitis. This review do not attempt to compare the effect of different regimens (...) Antibiotics versus placebo for prevention of postoperative infection after appendicectomy. Appendicitis is the most common cause of acute abdominal pain requiring surgical intervention. The cause of appendicitis is unclear and the mechanism of pathogenesis continues to be debated. Despite improved asepsis and surgical techniques, postoperative complications, such as wound infection and intraabdominal abscess, still account for a significant morbidity. Several studies implicate

2001 Cochrane

1340. Antibiotic prophylaxis for mammalian bites. Full Text available with Trip Pro

Antibiotic prophylaxis for mammalian bites. Bites by mammals are a common problem and they account for up to 1% of all visits to hospital emergency rooms. Dog and cat bites are the most common and people are usually bitten by their own pets or by an animal known to them. School-age children make up almost a half of those bitten. Prevention of tetanus, rabies and wound infection are the priorities for staff in emergency rooms. The use of antibiotics may be useful to reduce the risk of developing (...) a wound infection.To determine if the use of prophylactic antibiotics in mammalian bites is effective in preventing bite wound infection.Relevant RCTs were identified by electronic searches of MEDLINE, EMBASE, LILACS and the Cochrane Controlled Trials Register databases in November 2000.We included randomised controlled trials which studied patients with bites from all mammals. Comparisons were made between antibiotics and placebo or no intervention. The outcome of interest was the number

2001 Cochrane