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

1541. 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

1542. 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

1543. A controlled trial in intensive care units of selective decontamination of the digestive tract with nonabsorbable antibiotics

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.

1992 NHS Economic Evaluation Database.

1544. Antimicrobial therapy for otitis media with effusion ('secretory' otitis media). (Abstract)

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

1991 JAMA Controlled trial quality: predicted high

1545. Acute red ear in children: controlled trial of non-antibiotic treatment in general practice. Full Text available with Trip Pro

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

1991 BMJ Controlled trial quality: predicted high

1546. Role of candida in pathogenesis of antibiotic-associated diarrhoea in elderly inpatients. (Abstract)

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

1991 Lancet

1547. Reduced intravascular catheter infection by antibiotic bonding. A prospective, randomized, controlled trial. (Abstract)

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

1991 JAMA Controlled trial quality: uncertain

1548. Perioperative antibiotic prophylaxis for herniorrhaphy and breast surgery. (Abstract)

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.

1990 NEJM Controlled trial quality: predicted high

1549. Immunomodulatory and antimicrobial efficacy of intravenous immunoglobulin in bone marrow transplantation. (Abstract)

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

1990 NEJM Controlled trial quality: uncertain

1550. Early antibiotic treatment of reactive arthritis associated with enteric infections: clinical and serological study. Full Text available with Trip Pro

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

1990 BMJ Controlled trial quality: uncertain

1551. Postcoital antimicrobial prophylaxis for recurrent urinary tract infection. A randomized, double-blind, placebo-controlled trial. (Abstract)

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

1990 JAMA Controlled trial quality: uncertain

1552. Effect of short-term intermittent antibiotic treatment on growth of Burmese (Myanmar) village children. (Abstract)

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

1990 Lancet Controlled trial quality: uncertain

1553. Cost-effectiveness of antibiotic prophylaxis for dental procedures in patients with artificial joints

Cost-effectiveness of antibiotic prophylaxis for dental procedures in patients with artificial joints Cost-effectiveness of antibiotic prophylaxis for dental procedures in patients with artificial joints Cost-effectiveness of antibiotic prophylaxis for dental procedures in patients with artificial joints Tsevat J, Durand-Zaleski I, Pauker S 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 using erythromycin or penicillin. Type of intervention Primary prevention. Economic study type Cost-utility analysis. Study population Patients with artificial joints. Setting The study was carried out in the USA. Dates to which data relate Price related to 1986. Source of effectiveness data Literature

1989 NHS Economic Evaluation Database.

1554. A cost-effectiveness comparison of the use of antimicrobial agents for the treatment or prophylaxis of travellers' diarrhoea

A cost-effectiveness comparison of the use of antimicrobial agents for the treatment or prophylaxis of travellers' diarrhoea A cost-effectiveness comparison of the use of antimicrobial agents for the treatment or prophylaxis of travellers' diarrhoea A cost-effectiveness comparison of the use of antimicrobial agents for the treatment or prophylaxis of travellers' diarrhoea Reves R R, Johnson P C, Ericsson C D, DuPont H L Record Status This is a critical abstract of an economic evaluation (...) although incapacitation days might be a useful proxy measure. 2) 85% effectiveness is optimistically assumed in prophylactic use: this may not be achieved when local antimicrobial resistance has developed. 3) The main influence for the savings is the value of incapacitation days, determined as loss of investment - a conservative evaluation of production loss. 4) The quality of evidence is poor but the findings appear robust in the sensitivity analysis. Bibliographic details Reves R R, Johnson P C

1988 NHS Economic Evaluation Database.

1555. Antibiotics or placebo for chronic obstructive pulmonary disease. (Abstract)

Antibiotics or placebo for chronic obstructive pulmonary disease. 3592433 1987 07 20 2004 11 17 0003-4819 107 1 1987 Jul Annals of internal medicine Ann. Intern. Med. Antibiotics or placebo for chronic obstructive pulmonary disease. 117-8 Dudek J J JJ Heaney R M RM eng Clinical Trial Letter Randomized Controlled Trial United States Ann Intern Med 0372351 0003-4819 0 Anti-Bacterial Agents 0 Placebos AIM IM Anti-Bacterial Agents therapeutic use Humans Lung Diseases, Obstructive complications

1987 Annals of Internal Medicine Controlled trial quality: predicted high

1556. Antibiotic elimination of group-B streptococci in urine in prevention of preterm labour. (Abstract)

Antibiotic elimination of group-B streptococci in urine in prevention of preterm labour. The presence of group-B streptococci in the urine of pregnant women seems to be associated with preterm labour. Urine samples from 4122 women at 27-31 weeks' gestation were examined for bacteria. Group-B streptococci were found in the urine of 69 women. In a double-blind, controlled study these patients were given either penicillin (10(6) IU three times daily for 6 days; 37 patients) or placebo (32 patients

1987 Lancet Controlled trial quality: uncertain

1557. Antibiotic administration to treat possible occult bacteremia in febrile children. (Abstract)

Antibiotic administration to treat possible occult bacteremia in febrile children. We performed a prospective, randomized, placebo-controlled, double-blind clinical trial of antibiotic administration to treat possible occult bacteremia in febrile children. A total of 955 children aged 3 to 36 months with temperatures greater than or equal to 39.0 degrees C and no focal bacterial infection were enrolled at the emergency departments of two children's hospitals from January 1982 until July 1984 (...) infectious morbidity associated with bacteremia between the antibiotic and placebo groups--2 of 19 patients (10.5 percent) in the antibiotic group and 1 of 8 (12.5 percent) in the placebo group--although the power for this comparison was low. Antibiotics reduced fever (P less than 0.005) and improved the clinical appearance (P = 0.07) in the children with bacteremia but not in those without bacteremia. Although there were no statistically significant differences in the incidence of side effects, diarrhea

1987 NEJM Controlled trial quality: predicted high

1558. Ceftazidime combined with a short or long course of amikacin for empirical therapy of gram-negative bacteremia in cancer patients with granulocytopenia. The EORTC International Antimicrobial Therapy Cooperative Group. (Abstract)

Ceftazidime combined with a short or long course of amikacin for empirical therapy of gram-negative bacteremia in cancer patients with granulocytopenia. The EORTC International Antimicrobial Therapy Cooperative Group. To determine whether combination antibiotic therapy including a short course of an aminoglycoside was as effective and less toxic than a conventional long course of the combination for the empirical therapy of gram-negative bacteremia in patients with cancer and granulocytopenia (...) , we conducted a randomized multicenter trial comparing ceftazidime plus a short course (three days) of amikacin, ceftazidime plus a long course (nine days) of amikacin, and azlocillin plus a long course (nine days) of amikacin. Single-organism gram-negative bacteremia occurred in 129 of 872 evaluable patients. Without a change in antibiotics, the response rates were 81 percent with ceftazidime and long-course amikacin, 48 percent with ceftazidime and short-course amikacin (P = 0.002), and 40

1987 NEJM Controlled trial quality: uncertain

1559. Relative importance of antibiotic and improved clearance in topical treatment of chronic mucopurulent rhinosinusitis. A controlled study. (Abstract)

Relative importance of antibiotic and improved clearance in topical treatment of chronic mucopurulent rhinosinusitis. A controlled study. 50 patients with chronic mucopurulent rhinosinusitis were randomly allocated to treatment with nasal sprays of dexamethasone, tramazoline, and neomycin, dexamethasone and tramazoline with no antibiotic, or matched placebo (propellant alone) four times daily to both nostrils for 2 weeks. The patients were assessed in a double-blind manner for symptomatic (...) response and improvement in nasal mucociliary clearance, nasal airway resistance, sinus radiographs, and intranasal bacteriology and appearance. Both active preparations (with antibiotic 14 of 20 patients responded; without antibiotic 12 of 20 patients responded) were more effective than the placebo (2 of 10 patients responded). There was no significant difference in response between the active preparations with and without antibiotic. Thus, in treatment of chronic mucopurulent rhinosinusitis

1986 Lancet Controlled trial quality: uncertain

1560. A randomized trial comparing ceftazidime alone with combination antibiotic therapy in cancer patients with fever and neutropenia. (Abstract)

percent were alive at 72 hours and 89 percent when the neutropenia resolved, as compared with 98 percent and 91 percent, respectively, of those given combination therapy. The majority of episodes of documented infection in both treatment groups necessitated additional antimicrobial treatment or other modifications of the initial regimen, as compared with only 22 percent of the episodes of unexplained fever. We conclude that initial single-agent therapy with certain beta-lactam antibiotics is a safe (...) A randomized trial comparing ceftazidime alone with combination antibiotic therapy in cancer patients with fever and neutropenia. To assess the efficacy of single-agent therapy relative to standard combination antibiotic therapy for the initial management of fever and neutropenia in cancer patients, we conducted a randomized trial comparing ceftazidime alone with a combination of cephalothin, gentamicin, and carbenicillin. Of 550 evaluable episodes of fever and neutropenia, 282 were treated

1986 NEJM Controlled trial quality: uncertain