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

1441. Persistence of improvement in antibiotic prescribing in office practice. (Abstract)

Persistence of improvement in antibiotic prescribing in office practice. We evaluated persistence of the prescribing improvement seen in a previous statewide controlled trial, which measured improvement in the prescribing of contraindicated antibiotics and oral cephalosporins in the year after an educational intervention. Doctors visited by physician-counselors substantially improved their prescribing of both classes of drugs. The beneficial effect of the physician-counselors persisted

1985 JAMA

1442. Benefit-cost analysis of antimicrobial prophylaxis in abdominal and vaginal hysterectomy. (Abstract)

Benefit-cost analysis of antimicrobial prophylaxis in abdominal and vaginal hysterectomy. We performed a benefit-cost analysis of antimicrobial prophylaxis for hysterectomy using data from a randomized, placebo-controlled clinical trial of the efficacy of three doses of cefazolin sodium. The excess cost per patient with either operative site or urinary tract infection, or febrile morbidity diagnosed during hospitalization, was +1,777 for vaginal and +716 for abdominal hysterectomy. In patients

1983 JAMA

1443. Double-blind study to compare the selection of antibiotic resistance by amoxycillin or cephradine in the commensal flora. (Abstract)

Double-blind study to compare the selection of antibiotic resistance by amoxycillin or cephradine in the commensal flora. Elderly patients with acute urinary infections were treated in a double-blind study with either amoxycillin or cephradine. In 52 patients who had received amoxycillin for one week about a third of all intestinal Escherichia coli were highly resistant to amoxycillin, and many were resistant to tetracycline, trimethoprim, or chloramphenicol. Cephradine selected less resistance (...) . At a week after completion of chemotherapy, cephradine-resistant E coli were replaced by sensitive cultures at a greater frequency than were amoxycillin-resistant E coli. Neither antibiotic altered the skin flora. Amoxycillin, but not cephradine, selected for Enterobacteriaceae in the saliva. The propensity of amoxycillin to select resistance in E coli will limit its usefulness in treating urinary infections.

1983 Lancet Controlled trial quality: uncertain

1444. Improving antibiotic prescribing in office practice. A controlled trial of three educational methods. (Abstract)

Improving antibiotic prescribing in office practice. A controlled trial of three educational methods. We conducted a statewide controlled trial of three methods to improve antibiotic prescribing in office practice: a mailed brochure, a drug educator visit, and a physician visit. Educational topics were three antibiotics contraindicated for office practice and oral cephalosporins. Medicaid prescribing data were used to select donors who needed education. The effect of the methods was evaluated (...) by comparing the change in prescribing (the year before the intervention v the year after the intervention) for the doctors receiving education with the prescribing of comparable doctors chosen as controls. The mailed brochure had no detectable effect, and the drug educator had only a modest effect. The physician visits produced strong attributable reductions in prescribing of both drug classes. For the contraindicated antibiotics, the reductions were 18% in number of doctors prescribing, 44% in number

1983 JAMA

1445. Routine antibiotics in hospital management of acute asthma. (Abstract)

Routine antibiotics in hospital management of acute asthma. The value of antibiotics was assessed in a randomised, double-blind study of amoxycillin and placebo in sixty adults admitted to hospital with acute exacerbations of asthma. 37 exacerbations were treated with amoxycillin and 34 were treated with placebo. Response to treatment was closely monitored but no significant difference in improvement was demonstrated between groups for length of hospital stay, time taken for 50% improvement (...) in symptoms, patient's self assessment and respiratory function, and symptoms and respiratory function at time of discharge from hospital. Antibiotics should not be given routinely to patients admitted to hospital with acute exacerbations of asthma.

1982 Lancet Controlled trial quality: uncertain

1446. Therapy of acute otitis media: myringotomy, antibiotics, or neither? A double-blind study in children. (Abstract)

Therapy of acute otitis media: myringotomy, antibiotics, or neither? A double-blind study in children. In a double-blind study 171 children with acute otitis media (239 affected ears) were treated by four different methods: neither antibiotics nor myringotomy; myringotomy only; antibiotics only; or both antibiotics and myringotomy. All received symptomatic treatment. There were no significant differences in clinical course (pain, temperature, duration of discharge, otoscopic appearances (...) , audiography, recurrence rate) between the four groups. In the groups treated without antibiotics, the ears discharge for slightly longer and the eardrums took a little longer to heal; these differences were not significant. No complications were seen. Symptomatic therapy with nosedrops and analgesics seems a reasonable initial approach to acute otitis media in children. Myringotomy and antibiotics can be reserved for cases in which the course of otitis is irregular, there are complications

1981 Lancet Controlled trial quality: uncertain

1447. Prophylactic antibiotics in simple hand lacerations. (Abstract)

Prophylactic antibiotics in simple hand lacerations. A randomized prospective study of 265 patients with hand lacerations was carried out to define the role of prophylactic antibiotics in the management of simple, sutured wounds of the hand. Two hundred sixty-five patients were followed up until suture removal or satisfactory wound healing. There were a total of three infections (1.1%). There was no noticeable differences in the incidence of infection in the antibiotic and placebo treatment (...) groups. It is concluded that prophylactic antibiotics are an unnecessary adjunct in the treatment of simple lacerations of the hand and no replacement for meticulous wound management.

1981 JAMA Controlled trial quality: uncertain

1448. Antimicrobial vs placebo prophylaxis in noncardiac thoracic surgery. (Abstract)

Antimicrobial vs placebo prophylaxis in noncardiac thoracic surgery. A prospective, double-blind evaluation of the efficacy and safety of prophylactic cephalosporins was done in 57 patients undergoing noncardiac thoracic surgery. Twenty-eight received cephalosporin therapy, and 29 received placebo. Overall, the incidence of postoperative infections was the same; infections developed in five (17.8%) of the 28 patients in the cephalosporin group and in five (17.2%) of the 29 patients

1979 JAMA Controlled trial quality: uncertain

1449. Comparison between systemic and oral antimicrobial prophylaxis in colorectal surgery. (Abstract)

antimicrobials orally were due to kanamycin-resistant bacteria present in the colon at operation. Bacterial overgrowth of Staphylococcus aureus was recorded in 6 of the patients who received oral therapy. Antibiotic-associated pseudomembranous colitis occurred in 7 patients, 6 of whom had received prophylaxis orally. These results indicate that oral administration of prophylactic antimicrobials in colon surgery should be avoided because of the risks of bacterial resistance, superinfection, and antibiotic (...) Comparison between systemic and oral antimicrobial prophylaxis in colorectal surgery. In a prospective randomised trial in which 93 patients undergoing elective colorectal operations were given a short prophylactic course of metronidazole and kanamycin orally or systemically, postoperative sepsis occurred in only 3 (6.5%) of those given antimicrobials systemically, compared with 17 (36%) of those given oral prophylaxis (P less than 0.01). 15 of the 17 infections in patients who received

1979 Lancet

1450. Antibiotic irrigation and catheter-associated urinary-tract infections. (Abstract)

Antibiotic irrigation and catheter-associated urinary-tract infections. To investigate the efficacy of antibiotic irrigation in preventing catheter-associated urinarytract infection, we carried out a randomized controlled trial of a neomycin-polymyxin irrigant administered through closed urinary catheters. Eighteen of 98 (18 per cent) of the patients not given irrigation became infected, as compared with 14 of 89 (16 per cent) of those given irrigation, yielding a mean daily incidence of 5 per (...) cent in each group. The distribution of organisms and their antibiotic sensitivities differed in the two groups, the organisms from the patients with irrigation being more resistant. Disconnections of the catheter junctions were associated with high rates of infection. The rate of disconnections of the junctions in the group given irrigation was almost twice that of the control group because of the presence of the extra junction on overall infection rate represents the result of two opposing

1978 NEJM Controlled trial quality: uncertain

1451. Prophylactic systemic antibiotics in colorectal surgery. (Abstract)

Prophylactic systemic antibiotics in colorectal surgery. The prophylactic value of gentamicin combined with either lincomycin or metronidazole in 52 patients undergoing colorectal surgery was investigated. The results confirmed the value of this practice. In a control group, the sepsis-rate was 48% with 1 death attributable to sepsis, compared with a sepsis-rate of 4% in the treated group. The combination of gentamicin and lincomycin was effective against sepsis but pseudomembranous colitis

1977 Lancet Controlled trial quality: uncertain

1452. Oral non-absorbed antibiotics prevent infection in acute non-lymphoblastic leukaemia. (Abstract)

Oral non-absorbed antibiotics prevent infection in acute non-lymphoblastic leukaemia. 113 patients being treated for acute non-lymphoblastic leukaemia were investigated to determine the effect of suppression of body microbial flora on prevention of infection. They were randomly allocated to a control group or a group which received non-absorbed antibiotics by mouth and topical applications of cutaneous and mucosal antiseptic preparations. The group receiving oral non-absorbed antibiotics had (...) significantly few infections, fewer deaths from infection, fewer pyrexial episodes, and consequently received less systemic antibiotic therapy than the controls.

1977 Lancet

1453. Prevention of wound infection in abdominal operations by peroperative antibiotics or povidone-iodine. A controlled trial. (Abstract)

Prevention of wound infection in abdominal operations by peroperative antibiotics or povidone-iodine. A controlled trial. The wound-infection rate after abdominal operations was compared in 113 patients randomly allocated to an untreated control group, a group receiving preoperative lincomycin and tobramycin, or a group receiving local instillation of povidone-iodine. The wound-infection rate was 8.1% in 37 patients receiving antibiotics, 42.1% in 38 untreated controls, and 39.5% in 38 patients

1977 Lancet Controlled trial quality: uncertain

1454. Single-dose peroperative antibiotic prophylaxis in gastrointestinal surgery. (Abstract)

Single-dose peroperative antibiotic prophylaxis in gastrointestinal surgery. A single intravenous dose of tobramycin and lincomycin, given at the start of gastrointestinal operations, significantly reduced the incidence of postoperative wound infection from 34% to 5%. The occurrence of both anaerobic and aerobic bacteria was reduced. Therapeutic concentrations of the antibiotics were maintained throughout the operative period in most cases. No toxic effects of the antibiotics were detected (...) , no anaesthetic complication occurred, and resistant strains of bacteria normally sensitive to the antibiotics were not isolated from wounds.

1976 Lancet

1455. Controlled trial of prophylactic antibiotics in minor wounds requiring suture. (Abstract)

Controlled trial of prophylactic antibiotics in minor wounds requiring suture. Minor wounds presenting in the accident department requiring suture were randomly allocated to one of three treatment groups: an intramuscular injection of 1-25 megaunits of penicillin as a long-acting depot preparation, local wound irrigation with 100mg of tetracycline in solution, or no antibiotics. All wounds had a standard surgical toilet and were closed under aseptic conditions. Wound infections were noted five (...) to seven days after suture, and in the two groups receiving antibiotics 23% of the wounds were infected whilst in the control group the frequency was 7%. The wisdom of using routine antibiotic prophylaxis in minor wounds is questioned.

1975 Lancet

1456. Prophylactic oral antimicrobial agents in elective colonic surgery. A controlled trial. (Abstract)

Prophylactic oral antimicrobial agents in elective colonic surgery. A controlled trial. A controlled trial has been carried out in 50 patients undergoing elective colonic surgery to assess the efficacy of prophylactic oral metronidazole specifically directed against anaerobic colonic microflora in combination with kanamycin to reduce the aerobic flora. A control group received dietary and mechanical preparation alone. A significant reduction of both aerobic and anaerobic colonic microflora (...) was achieved in the group receiving prophylactic antimicrobial agents, and this was reflected in a significant reduction in postoperative wound infections. 1 control patient died from Bacteroides septicaemia. No toxic or other side-effects from this prophylactic regimen occurred in this trial.

1975 Lancet

1457. Antibiotic prophylaxis and cardiac surgery. A prospective double-blind comparison of single-dose versus multiple-dose regimens. (Abstract)

Antibiotic prophylaxis and cardiac surgery. A prospective double-blind comparison of single-dose versus multiple-dose regimens. 5027584 1972 07 26 2013 11 21 0003-4819 76 6 1972 Jun Annals of internal medicine Ann. Intern. Med. Antibiotic prophylaxis and cardiac surgery. A prospective double-blind comparison of single-dose versus multiple-dose regimens. 943-9 Conte J E JE Jr Cohen S N SN Roe B B BB Elashoff R M RM eng Clinical Trial Comparative Study Journal Article Randomized Controlled Trial

1972 Annals of Internal Medicine Controlled trial quality: uncertain

1458. Clinical and bacteriological evaluation of antibiotic treatment in shigellosis. (Abstract)

Clinical and bacteriological evaluation of antibiotic treatment in shigellosis. 5205234 1971 05 06 2016 10 17 0098-7484 214 10 1970 Dec 07 JAMA JAMA Clinical and bacteriological evaluation of antibiotic treatment in shigellosis. 1841-4 Tong M J MJ Martin D G DG Cunningham J J JJ Gunning J J JJ eng Clinical Trial Journal Article Randomized Controlled Trial United States JAMA 7501160 0098-7484 59-01-8 Kanamycin 7C782967RD Ampicillin AIM IM Administration, Oral Adolescent Adult Ampicillin

1971 JAMA Controlled trial quality: uncertain

1459. Ampicillin compared to other antimicrobials in acute otitis media. (Abstract)

Ampicillin compared to other antimicrobials in acute otitis media. 4964192 1967 12 21 2016 10 17 0098-7484 202 8 1967 Nov 20 JAMA JAMA Ampicillin compared to other antimicrobials in acute otitis media. 697-702 Bass J W JW Cohen S H SH Corless J D JD Mamunes P P eng Clinical Trial Comparative Study Journal Article Randomized Controlled Trial United States JAMA 7501160 0098-7484 0 Anti-Infective Agents 17R794ESYN Penicillin G Procaine 740T4C525W Sulfisoxazole 7C782967RD Ampicillin RIT82F58GK

1967 JAMA Controlled trial quality: uncertain