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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.
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
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
[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
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
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
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
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
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
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.
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
A controlled trial in intensive care units of selective decontamination of the digestive tract with nonabsorbable antibiotics 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.
Role of candida in pathogenesis of antibiotic-associated diarrhoea in elderly inpatients. The part that candida plays in antibiotic-associated diarrhoea was investigated in 24 elderly inpatients (mean age 74 years) who tested negative for Clostridium difficile toxin and other intestinal pathogens. 7 had intestinal overgrowth of Candida species (greater than or equal to 10(5) cfu/ml). None of the 24 matched, antibiotic-treated controls without diarrhoea had candida overgrowth. All 5 patients (...) with diarrhoea and candida overgrowth treated with oral nystatin responded with resolution of diarrhoea and lowering of faecal counts to less than 10(4) cfu/ml within 7 days of start of antifungal therapy despite continuation of antibacterial therapy. In the other 2 patients with candida overgrowth, the diarrhoea subsided spontaneously and faecal candida counts returned to normal (less than 10(4) cfu/ml) after antibacterial agents were withdrawn. In patients without candida overgrowth, diarrhoea persisted
Reduced intravascular catheter infection by antibiotic bonding. A prospective, randomized, controlled trial. We report a prospective, randomized, controlled clinical trial to evaluate the efficacy of antibiotic-bonded catheters in reducing the incidence of intravascular catheter-related infections. Ninety-three central venous catheters and 85 arterial catheters were studied in the surgical intensive care unit. Study catheters were pretreated with the cationic surfactant tridodecylmethylammonium (...) chloride. The anionic antibiotic, cefazolin, was bonded before insertion of the catheters by immersing them in a 50-mg/mL solution. Fourteen percent of the 81 catheters in the control group were infected, compared with 2% of the 97 antibiotic-bonded catheters. Staphylococcus epidermidis was the most common organism obtained. There was no significant difference in the number of colonized or clinically inflamed catheter insertion sites. None of the 100 antibiotic immersion solutions yielded anything
Acute red ear in children: controlled trial of non-antibiotic treatment in general practice. To examine the efficacy and safety of conservative management of mild otitis media ("the acute red ear") in children.Double blind placebo controlled trial.17 group general practices (48 general practitioners) in Southampton, Bristol, and Portsmouth.232 children aged 3-10 years with acute earache and at least one abnormal eardrum (114 allocated to receive antibiotic, 118 placebo).Amoxycillin 125 mg three (...) times a day for seven days or matching placebo; 100 ml paracetamol 120 mg/5 ml.Diary records of pain and crying, use of analgesic, eardrum signs, failure of treatment, tympanometry at one and three months, recurrence rate, and ear, nose, and throat referral rate over one year.Treatment failure was eight times more likely in the placebo than the antibiotic group (14.4% v 1.7%, odds ratio 8.21, 95% confidence interval 1.94 to 34.7). Children in the placebo group showed a significantly higher incidence
Antimicrobial therapy for otitis media with effusion ('secretory' otitis media). To determine the effectiveness of antimicrobial treatment for otitis media with effusion ("secretory" otitis media) in children.We report the reexamination of a previously published study by Mandel et al that evaluated the efficacy of a 2-week course of antimicrobials (amoxicillin trihydrate) with and without a 4-week course of an oral decongestant-antihistamine combination in a double-blind, placebo-controlled (...) and prognostic factors showed no significant differences between placebo- and antibiotic-treated groups for unilateral effusions and for bilateral effusions. When subjects with unilateral and bilateral effusions were combined, the estimated efficacy of antibiotic treatment was 12.3% by otoscopy (P = .014) and 4.8% by tympanometry (P = .171). We also demonstrate the sensitivity of outcome to diagnostic measures used and provide statistical evidence questioning the validity of otoscopic observations
Perioperative antibiotic prophylaxis for herniorrhaphy and breast surgery. We assessed the efficacy of perioperative antibiotic prophylaxis for surgery in a randomized, double-blind trial of 1218 patients undergoing herniorrhaphy or surgery involving the breast, including excision of a breast mass, mastectomy, reduction mammoplasty, and axillary-node dissection. The prophylactic regimen was a single dose of cefonicid (1 g intravenously) administered approximately half an hour before surgery (...) ). There were also comparable reductions in the need for postoperative antibiotic therapy, non-routine visits to a physician for problems involving wound healing, incision and drainage procedures, and readmission because of problems with wound healing. We conclude that perioperative antibiotic prophylaxis with cefonicid is useful for herniorrhaphy and certain types of breast surgery.
Postcoital antimicrobial prophylaxis for recurrent urinary tract infection. A randomized, double-blind, placebo-controlled trial. We conducted a randomized, double-blind, placebo-controlled study to determine the efficacy of postcoital antibiotic prophylaxis in healthy young women prone to recurrent urinary tract infections. Sixteen patients were randomized to receive postcoital administration of a combination product of trimethoprim and sulfamethoxazole, while 11 received postcoital placebo
Effect of short-term intermittent antibiotic treatment on growth of Burmese (Myanmar) village children. To test the hypothesis that subclinical enteric infection (such as bacterial overgrowth), rice malabsorption, and growth faltering are causally linked, a field trial of low-dose, short-term, intermittent antibiotic treatment was carried out in 142 hydrogen-producing (by lactulose breath hydrogen test) Burmese village children aged 6-59 months. The children were randomly allocated treatment (...) with metronidazole (20 mg/kg or 5 mg/kg daily), amoxycillin (25 mg/kg daily), or placebo given 1 week per month for 6 months. A cooked rice meal breath hydrogen test was done to classify the children as rice absorbers (RA) or rice malabsorbers (RM) before treatment and monthly on the day before each cycle of treatment. There were no differences between the treatment groups, so they were considered together. Factorial analysis showed that antibiotic treatment did not significantly affect the proportion of RM
Early antibiotic treatment of reactive arthritis associated with enteric infections: clinical and serological study. To find out whether a 10-14 days' course of antibiotics early in the course of reactive arthritis associated with enteric infections could reduce the severity and duration of the disease and whether the antibody response in patients with reactive arthritis associated with yersinia infection differed between those treated and those not treated with the antibiotics.Prospective (...) multicentre trial in which patients were randomised to treatment or no treatment with antibiotics. Patients were seen at three and six weeks and three, six, nine, 12, and 18 months after their first visit.Departments of infectious diseases in three hospitals in Linköping, Malmö, and Stockholm, Sweden.40 Consecutive patients who had had symptoms of reactive arthritis associated with enteric infection for less than four weeks.20 Patients were allocated to treatment with antibiotics and 20 patients did
Immunomodulatory and antimicrobial efficacy of intravenous immunoglobulin in bone marrow transplantation. Graft-versus-host disease (GVHD) and infection are major complications of allogeneic bone marrow transplantation. Since intravenous immunoglobulin has shown benefit in several immunodeficiency and autoimmune disorders, we studied its antimicrobial and immunomodulatory role after marrow transplantation.In a randomized trial of 382 patients, transplant recipients given immunoglobulin (500 mg