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

1401. Evaluation of an antibiotic prescribing protocol for treatment of acute exacerbations of chronic obstructive airways disease in a hospital respiratory unit

Evaluation of an antibiotic prescribing protocol for treatment of acute exacerbations of chronic obstructive airways disease in a hospital respiratory unit Evaluation of an antibiotic prescribing protocol for treatment of acute exacerbations of chronic obstructive airways disease in a hospital respiratory unit Evaluation of an antibiotic prescribing protocol for treatment of acute exacerbations of chronic obstructive airways disease in a hospital respiratory unit Boyter A C, Davey P G, Hudson S (...) A, Clark R A, Lipworth B J 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 Use of antibiotics in the treatment of infective exacerbations of chronic obstructive airways disease (COAD). First line therapy was oral amoxycillin 500mg tid

1995 NHS Economic Evaluation Database.

1402. Cost analysis of antibiotic prophylaxis in clean head and neck surgery

Cost analysis of antibiotic prophylaxis in clean head and neck surgery Cost analysis of antibiotic prophylaxis in clean head and neck surgery Cost analysis of antibiotic prophylaxis in clean head and neck surgery Blair E A, Johnson J T, Wagner R L, Carrau R L, Bizakis J G 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 Antibiotic prophylaxis in clean head and neck surgery. Type of intervention Secondary prevention. Economic study type Cost-effectiveness study. Study population The study population comprised patients who underwent clean neck dissection: patients with exposure to secretions from the upper aerodigestive tract were excluded. The mean age in the antibiotic prophylaxis group was 60 (range 24-91

1995 NHS Economic Evaluation Database.

1403. Randomized comparative trial and cost analysis of 3-day antimicrobial regimens for treatment of acute cystitis in women

Randomized comparative trial and cost analysis of 3-day antimicrobial regimens for treatment of acute cystitis in women Randomized comparative trial and cost analysis of 3-day antimicrobial regimens for treatment of acute cystitis in women Randomized comparative trial and cost analysis of 3-day antimicrobial regimens for treatment of acute cystitis in women Hooton T M, Winter C, Tiu F, Stamm W E 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 Three-day oral antimicrobial drug therapies for acute uncomplicated cystitis in women: trimethoprim-sulfamethoxazole (160mg/800mg twice daily) or macrocrystalline nitrofurantoin (100mg four times daily) or cefadroxil (500mg twice daily) or amoxicillin (5 00mg three times daily

1995 NHS Economic Evaluation Database.

1404. Pharmacoeconomic analysis of empirical therapy with ceftazidime alone or combination antibiotics for febrile neutropenia in cancer patients

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 A single-agent broad spectrum antibacterial (ceftazidime) compared with two combination antibiotic regimens (tobramycin plus piperacillin with cefazolin (CAP), and tobramycin plus piperacillin without cefazolin (AP (...) Pharmacoeconomic analysis of empirical therapy with ceftazidime alone or combination antibiotics for febrile neutropenia in cancer patients Pharmacoeconomic analysis of empirical therapy with ceftazidime alone or combination antibiotics for febrile neutropenia in cancer patients Pharmacoeconomic analysis of empirical therapy with ceftazidime alone or combination antibiotics for febrile neutropenia in cancer patients Dranitsaris G, Tran T M, McGeer A, Narine L Record Status This is a critical

1995 NHS Economic Evaluation Database.

1405. Computer-assisted antimicrobial surveillance in a community teaching hospital

Computer-assisted antimicrobial surveillance in a community teaching hospital Computer-assisted antimicrobial surveillance in a community teaching hospital Computer-assisted antimicrobial surveillance in a community teaching hospital Jozefiak E T, Lewicki J E, Kozinn W P 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 Antimicrobial surveillance service combining computer-assisted information management with clinical review and intervention by pharmacists. Type of intervention Prescribing management; Treatment. Economic study type Cost-effectiveness analysis. Study population Patients admitted to a community teaching hospital. Setting Hospital. The study was carried out in Philadelphia, USA. Dates to which data relate

1995 NHS Economic Evaluation Database.

1406. Home intravenous antibiotic therapy: a safe and effective alternative to inpatient care

Home intravenous antibiotic therapy: a safe and effective alternative to inpatient care Home intravenous antibiotic therapy: a safe and effective alternative to inpatient care Home intravenous antibiotic therapy: a safe and effective alternative to inpatient care Grayson M L, Silvers J, Turnidge J 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 Intravenous antibiotic therapy administered at home to early-discharge patients with serious bacterial infections. Type of intervention Treatment. Economic study type Cost-effectiveness analysis Study population To be eligible for home intravenous therapy, patients had to satisfy the following criteria: stable clinical and psychological condition; established long-term venous access

1995 NHS Economic Evaluation Database.

1407. [Antibiotic treatment of bacterial meningitis in children--results from a Finnish multicenter study]. (Abstract)

[Antibiotic treatment of bacterial meningitis in children--results from a Finnish multicenter study]. 1364751 1994 12 05 2013 11 21 0012-7183 107 3 1991 Duodecim; laaketieteellinen aikakauskirja Duodecim [Antibiotic treatment of bacterial meningitis in children--results from a Finnish multicenter study]. 149-57 Anttila M M Ulkoasiainministeriön kehitysyhteistyöosasto, Helsinki, Finland. Anttolainen I I Ellmén J J Eskola J J Joki T T Kaartinen L L Kaski U U Kataja M M Kojo N N Korppi M M fin

1994 Duodecim; laaketieteellinen aikakauskirja Controlled trial quality: uncertain

1408. A randomized placebo-controlled trial of Saccharomyces boulardii in combination with standard antibiotics for Clostridium difficile disease. (Abstract)

A randomized placebo-controlled trial of Saccharomyces boulardii in combination with standard antibiotics for Clostridium difficile disease. OBJECTIVE--To determine the safety and efficacy of a new combination treatment for patients with Clostridium difficile-associated disease (CDD). The treatment combines the yeast Saccharomyces boulardii with an antibiotic (vancomycin hydrochloride or metronidazole). DESIGN--A double-blind, randomized, placebo-controlled, parallel-group intervention study (...) in patients with active CDD. Patients received standard antibiotics and S boulardii or placebo for 4 weeks, and were followed up for an additional 4 weeks after therapy. Effectiveness was determined by comparing the recurrence of CDD in the two groups using multivariate analysis to control for other risk factors for CDD. SETTING--National referral study of ambulatory or hospitalized patients from three main study coordinating centers. PATIENTS--A total of 124 eligible consenting adult patients, including

1994 JAMA Controlled trial quality: predicted high

1409. Reduction of fever and streptococcal bacteremia in granulocytopenic patients with cancer. A trial of oral penicillin V or placebo combined with pefloxacin. International Antimicrobial Therapy Cooperative Group of the European Organization for Research and (Abstract)

Reduction of fever and streptococcal bacteremia in granulocytopenic patients with cancer. A trial of oral penicillin V or placebo combined with pefloxacin. International Antimicrobial Therapy Cooperative Group of the European Organization for Research and To determine the effect of oral penicillin V combined with a fluoroquinolone (pefloxacin) on the occurrence of fever and streptococcal and other gram-positive coccal bacteremic infections in granulocytopenic patients with cancer.Prospective

1994 JAMA Controlled trial quality: predicted high

1410. [Cost-effectiveness of preventive antibiotic administration for lowering risk of infection by 0.25%]

[Cost-effectiveness of preventive antibiotic administration for lowering risk of infection by 0.25%] Kosteneffektivitat einer Antibiotikaprophylaxe bei Senkung des Infektionsrisikos um 0.25% [Cost-effectiveness of preventive antibiotic administration for lowering risk of infection by 0.25%] Kosteneffektivitat einer Antibiotikaprophylaxe bei Senkung des Infektionsrisikos um 0.25% [Cost-effectiveness of preventive antibiotic administration for lowering risk of infection by 0.25%] Albers B (...) A, Patka P, Haarman H J, Kostense P J 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 Antibiotic prophylaxis preventing postoperative infections of closed fractures. Type of intervention Primary prevention. Economic study type Cost

1994 NHS Economic Evaluation Database.

1411. Clinical efficacy of antimicrobial drugs for acute otitis media: metaanalysis of 5400 children from thirty-three randomized trials

of antimicrobial drug. Results of the review Thirty-three RCTs, of which 47% were not double-blind, were included. The spontaneous rate of primary control without treatment was 81% (95% CI: 69, 94). Compared with placebos or no drug, the rate difference for primary control for penicillin was 15.7% (95% CI: 4.7, 26.7), for aminopenicillin 12.9% (95% CI: 6.8, 19.0), and for any antibiotic 13.7% (95% CI: 8.2, 19.2). Six of every 7 children with acute otitis media either do not need antibiotics for primary control (...) , or will not respond to antibiotic therapy (NNT = 7). Results from the fixed-effect and random-effects analyses were consistent. No significant differences were found between various antimicrobial agents. The sensitivity analysis showed that these results were robust to quality and diagnostic screening. Authors' conclusions Antimicrobial drugs have a modest but significant impact on the primary control of acute otitis media. Treatment with extended spectrum antibiotics does not increase resolution of acute

1994 DARE.

1412. Does topical antibiotic prophylaxis reduce post-tympanostomy tube otorrhea?

Does topical antibiotic prophylaxis reduce post-tympanostomy tube otorrhea? Does topical antibiotic prophylaxis reduce post-tympanostomy tube otorrhea? Does topical antibiotic prophylaxis reduce post-tympanostomy tube otorrhea? Garcia P, Gates G A, Schechtman K B Authors' objectives To assess the efficacy of topical antimicrobial prophylaxis against purulent post-operative otorrhea. Searching MEDLARS (MEDLINE) was searched using the MeSHs 'tympanostomy', 'complications' and 'otorrhea' (search (...) dates unclear). Study selection Study designs of evaluations included in the review Prospective randomised controlled trials (RCTs) only were included. Specific interventions included in the review Topical antimicrobial prophylaxis of purulent post-operative otorrhea of at least 48 hours duration after insertion of tympanostomy tube. Participants included in the review Children with otitis media with effusion, and not on oral antimicrobial agents, were included. Outcomes assessed in the review

1994 DARE.

1413. [Proposal for shortened antibiotic therapy as a cost-saving measure in uncomplicated infections]

[Proposal for shortened antibiotic therapy as a cost-saving measure in uncomplicated infections] Anstoss zu verkurzter i.v. Antibiotikabehandlung als kostensparende Intervention bei der Behandlung unkomplizierter Infekte [Proposal for shortened antibiotic therapy as a cost-saving measure in uncomplicated infections] Anstoss zu verkurzter i.v. Antibiotikabehandlung als kostensparende Intervention bei der Behandlung unkomplizierter Infekte [Proposal for shortened antibiotic therapy as a cost (...) -saving measure in uncomplicated infections] Schmid J P, Regamey C 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 Shortening of intravenous (i.v.) antibiotic therapy in uncomplicated infections. Type of intervention Treatment

1994 NHS Economic Evaluation Database.

1414. Assessment of cost-effective antibiotic therapy in the management of infections in cancer patients

Single study. Link between effectiveness and cost data Costing was undertaken prospectively on the same patient sample as that used in the effectiveness study. Study sample Consensus guidelines for effective antibiotic therapy were developed following a baseline evaluation period of one month. A total of 149 patients receiving parenteral antimicrobial therapy were observed during this baseline period of which 23% were admitted to service 1, 70% to service 2 and 7% to service 3. Study design A total (...) promoted by a clinical pharmacist. For service 2 an average increase of $30 in the cost of antimicrobial therapy per patient was observed during the intervention period compared with that of the baseline period. Authors' conclusions The results suggested that a consensus approach to antibiotic therapy can be cost-effective. A clinical pharmacist intervention may add significantly to quality improvement and cost-effective efforts in a hospital setting. CRD Commentary This was a poorly designed study

1994 NHS Economic Evaluation Database.

1415. Empirical parenteral antibiotic treatment of patients with fibromyalgia and fatigue and a positive serologic result for Lyme disease

Empirical parenteral antibiotic treatment of patients with fibromyalgia and fatigue and a positive serologic result for Lyme disease Empirical parenteral antibiotic treatment of patients with fibromyalgia and fatigue and a positive serologic result for Lyme disease Empirical parenteral antibiotic treatment of patients with fibromyalgia and fatigue and a positive serologic result for Lyme disease Lightfoot R W, Luft B J, Rahn D W, Steere A C, Sigal L H, Zoschke D C, Gardner P, Britton M C (...) studies included Not stated. Methods of combining primary studies Narrative method. Investigation of differences between primary studies Not reported. Results of the review In a population of 100,000, 2% will have the fatigue and myalgia syndrome due to causes other than Lyme disease. Of these, 2% will be falsely seropositive for Lyme disease. If all seropositive patients were treated with antibiotics for the possibility of Lyme disease, 3% will develop minor toxicity and 0.052 patients will develop

1993 NHS Economic Evaluation Database.

1416. Efficacy of antibiotic prophylaxis for prevention of native-valve endocarditis. (Abstract)

Efficacy of antibiotic prophylaxis for prevention of native-valve endocarditis. Whether antibiotic prophylaxis can prevent bacterial endocarditis is hotly debated. In an attempt to settle this issue, we have assessed the efficacy of prophylaxis for bacterial endocarditis on native valves in a nationwide, case-control study in the Netherlands. Cases were patients with known cardiac disease in whom endocarditis developed within 180 days of a medical or dental procedure for which prophylaxis

1992 Lancet Controlled trial quality: uncertain

1417. The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. (Abstract)

The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. Randomized, controlled trials have shown that prophylactic antibiotics are effective in preventing surgical-wound infections. However, it is uncertain how the timing of antibiotic administration affects the risk of surgical-wound infection in actual clinical practice.We prospectively monitored the timing of antibiotic prophylaxis and studied the occurrence of surgical-wound infections in 2847 (...) patients undergoing elective clean or "clean-contaminated" surgical procedures at a large community hospital. The administration of antibiotics 2 to 24 hours before the surgical incision was defined as early; that during the 2 hours before the incision, as preoperative; that during the 3 hours after the incision, as perioperative; and that more than 3 but less than 24 hours after the incision, as postoperative.Of the 1708 patients who received the prophylactic antibiotics preoperatively, 10 (0.6

1992 NEJM Controlled trial quality: uncertain

1418. A controlled trial in intensive care units of selective decontamination of the digestive tract with nonabsorbable antibiotics. The French Study Group on Selective Decontamination of the Digestive Tract. (Abstract)

A controlled trial in intensive care units of selective decontamination of the digestive tract with nonabsorbable antibiotics. The French Study Group on Selective Decontamination of the Digestive Tract. Selective decontamination of the digestive tract with topical nonabsorbable antibiotics has been reported to prevent nosocomial infections in patients receiving mechanical ventilation, and the procedure is used widely in Europe. However, it is unclear whether selective decontamination improves (...) survival.We conducted a randomized, double-blind multicenter study in which 445 patients receiving mechanical ventilation in 15 intensive care units were given either prophylactic nonabsorbable antibiotics (n = 220) or a placebo (n = 225). Topical antibiotics (tobramycin, colistin sulfate, and amphotericin B) or a placebo was administered through a nasogastric tube and applied to the oropharynx throughout the period of ventilation. The main end points were the mortality rate in the intensive care unit

1992 NEJM Controlled trial quality: predicted high

1419. A controlled trial of antimicrobial prophylaxis for Lyme disease after deer-tick bites. (Abstract)

A controlled trial of antimicrobial prophylaxis for Lyme disease after deer-tick bites. Borrelia burgdorferi, which causes Lyme disease, is transmitted by deer ticks (lxodes dammini) in the northeastern and midwestern United States. Although deer-tick bites are common in areas in which the disease is endemic, there is uncertainty about how to manage the care of persons who are bitten.To assess the risk of infection with B. burgdorferi and the efficacy of prophylactic antimicrobial treatment (...) interval, 0.1 to 4.1 percent), which was not significantly different (P = 0.22) from the risk in the amoxicillin-treated subjects (0 percent; 95 percent confidence interval, 0 to 1.5 percent).Even in an area in which Lyme disease is endemic, the risk of infection with B. burgdorferi after a recognized deer-tick bite is so low that prophylactic antimicrobial treatment is not routinely indicated.

1992 NEJM Controlled trial quality: predicted high

1420. Randomised comparison of oral ofloxacin alone with combination of parenteral antibiotics in neutropenic febrile patients. (Abstract)

Randomised comparison of oral ofloxacin alone with combination of parenteral antibiotics in neutropenic febrile patients. Prompt treatment with empirical antibiotics in neutropenic febrile patients reduces morbidity and mortality. Most patients have been treated with parenteral combination antibiotics, but newer antibiotics with broad-spectrum bactericidal activity have made monotherapy feasible. Ofloxacin, a broad-spectrum fluoroquinolone, has the additional advantage that bactericidal (...) concentrations can be achieved with oral administration. We have compared ofloxacin as an oral single agent with standard parenteral combination antibiotics for the management of neutropenic febrile patients in a prospective, randomised trial. Patients with severe neutropenia (absolute neutrophil count less than or equal to 0.5 x 10(9)/l), fever above 38 degrees C, and ability to take drugs by mouth were eligible for the study. After initial investigations, 60 patients were randomly assigned to oral

1992 Lancet Controlled trial quality: uncertain