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

61. Long-term follow-up of the AVOD randomized trial of antibiotic avoidance in uncomplicated diverticulitis (Abstract)

Long-term follow-up of the AVOD randomized trial of antibiotic avoidance in uncomplicated diverticulitis The aim of this study was to assess the long-term results in patients with uncomplicated diverticulitis who had participated in the Antibiotics in Acute Uncomplicated Diverticulitis (AVOD) RCT, which randomized patients with CT-verified left-sided acute uncomplicated diverticulitis to management without or with antibiotics.The medical records of patients who had participated in the AVOD (...) trial were reviewed for long-term results such as recurrences, complications and surgery. Quality-of-life questionnaires (EQ-5D™) were sent to patients, who were also contacted by telephone. Descriptive statistics were used for the analysis of clinical outcomes.A total of 556 of the 623 patients (89·2 per cent) were followed up for a median of 11 years. There were no differences between the no-antibiotic and antibiotic group in recurrences (both 31·3 per cent; P = 0·986), complications (4·4 versus 5

2019 EvidenceUpdates

62. Excess Antibiotic Treatment Duration and Adverse Events in Patients Hospitalized With Pneumonia: A Multihospital Cohort Study. (Abstract)

Excess Antibiotic Treatment Duration and Adverse Events in Patients Hospitalized With Pneumonia: A Multihospital Cohort Study. Randomized trials demonstrate no benefit from antibiotic treatment exceeding the shortest effective duration.To examine predictors and outcomes associated with excess duration of antibiotic treatment.Retrospective cohort study.43 hospitals in the Michigan Hospital Medicine Safety Consortium.6481 general care medical patients with pneumonia.The primary outcome (...) was the rate of excess antibiotic treatment duration (excess days per 30-day period). Excess days were calculated by subtracting each patient's shortest effective (expected) treatment duration (based on time to clinical stability, pathogen, and pneumonia classification [community-acquired vs. health care-associated]) from the actual duration. Negative binomial generalized estimating equations (GEEs) were used to calculate rate ratios to assess predictors of 30-day rates of excess duration. Patient outcomes

2019 Annals of Internal Medicine

63. Use of Antibiotics Without a Prescription in the U.S. Population: A Scoping Review. (Abstract)

Use of Antibiotics Without a Prescription in the U.S. Population: A Scoping Review. Use of antibiotics without a prescription may increase unnecessary and inappropriate drug use or doses as well as global risk for antimicrobial resistance.To perform a scoping review of research on the prevalence of nonprescription antibiotic use in the United States and to examine the factors that influence it.Searches of PubMed, EMBASE, CINAHL, Scopus, and relevant Web sites without language restrictions from (...) January 2000 to March 2019.Studies reporting nonprescription use of antibiotics, storage of antibiotics, intention to use antibiotics without a prescription, and factors influencing nonprescription use.Two reviewers independently screened citations and full texts and performed data abstraction.Of 17 422 screened articles, 31 met inclusion criteria. Depending on population characteristics, prevalence of nonprescription antibiotic use varied from 1% to 66%, storage of antibiotics for future use varied

2019 Annals of Internal Medicine

64. C-Reactive Protein Testing to Guide Antibiotic Prescribing for COPD Exacerbations. Full Text available with Trip Pro

C-Reactive Protein Testing to Guide Antibiotic Prescribing for COPD Exacerbations. Point-of-care testing of C-reactive protein (CRP) may be a way to reduce unnecessary use of antibiotics without harming patients who have acute exacerbations of chronic obstructive pulmonary disease (COPD).We performed a multicenter, open-label, randomized, controlled trial involving patients with a diagnosis of COPD in their primary care clinical record who consulted a clinician at 1 of 86 general medical (...) practices in England and Wales for an acute exacerbation of COPD. The patients were assigned to receive usual care guided by CRP point-of-care testing (CRP-guided group) or usual care alone (usual-care group). The primary outcomes were patient-reported use of antibiotics for acute exacerbations of COPD within 4 weeks after randomization (to show superiority) and COPD-related health status at 2 weeks after randomization, as measured by the Clinical COPD Questionnaire, a 10-item scale with scores ranging

2019 NEJM Controlled trial quality: predicted high

65. Prophylactic antibiotics in the prevention of infection after operative vaginal delivery (ANODE): a multicentre randomised controlled trial. Full Text available with Trip Pro

Prophylactic antibiotics in the prevention of infection after operative vaginal delivery (ANODE): a multicentre randomised controlled trial. Risk factors for maternal infection are clearly recognised, including caesarean section and operative vaginal birth. Antibiotic prophylaxis at caesarean section is widely recommended because there is clear systematic review evidence that it reduces incidence of maternal infection. Current WHO guidelines do not recommend routine antibiotic prophylaxis (...) for women undergoing operative vaginal birth because of insufficient evidence of effectiveness. We aimed to investigate whether antibiotic prophylaxis prevented maternal infection after operative vaginal birth.In a blinded, randomised controlled trial done at 27 UK obstetric units, women (aged ≥16 years) were allocated to receive a single dose of intravenous amoxicillin and clavulanic acid or placebo (saline) following operative vaginal birth at 36 weeks gestation or later. The primary outcome

2019 Lancet Controlled trial quality: predicted high

66. Antibiotic therapy for chronic infection with Burkholderia cepacia complex in people with cystic fibrosis. (Abstract)

Antibiotic therapy for chronic infection with Burkholderia cepacia complex in people with cystic fibrosis. Cystic fibrosis (CF) a life-limiting inherited disease affecting a number of organs, but classically associated with chronic lung infection and progressive loss of lung function. Chronic infection by Burkholderia cepacia complex (BCC) is associated with increased morbidity and mortality and therefore represents a significant challenge to clinicians treating people with CF. This review (...) examines the current evidence for long-term antibiotic therapy in people with CF and chronic BCC infection.The objective of this review is to assess the effects of long-term oral and inhaled antibiotic therapy targeted against chronic BCC lung infections in people with CF. The primary objective is to assess the efficacy of treatments in terms of improvements in lung function and reductions in exacerbation rate. Secondary objectives include quantifying adverse events, mortality and changes in quality

2019 Cochrane

67. Guideline-Based Clinical Assessment Versus Procalcitonin-Guided Antibiotic Use in Pneumonia: A Pragmatic Randomized Trial (Abstract)

Guideline-Based Clinical Assessment Versus Procalcitonin-Guided Antibiotic Use in Pneumonia: A Pragmatic Randomized Trial Efforts to reduce unnecessary and unnecessarily long antibiotic treatment for community-acquired pneumonia have been attempted through use of procalcitonin and through guidelines based on serial clinical assessment. Our aim is to compare guideline-based clinical assessment- and procalcitonin algorithm-guided antibiotic use among patients with community-acquired pneumonia.We (...) performed a pragmatic, randomized, multicenter trial from November 2012 to April 2015 at 12 French hospitals. We included emergency department (ED) patients older than 18 years with community-acquired pneumonia. Patients were randomly assigned to either the procalcitonin-guided or clinical assessment group. In accordance with past studies, we hypothesized that serial clinical assessment would be superior to procalcitonin-guided care. The primary outcome was antibiotic duration, and secondary outcomes

2019 EvidenceUpdates

68. CRP-guided antibiotic treatment in acute exacerbations of COPD in hospital admissions (Abstract)

CRP-guided antibiotic treatment in acute exacerbations of COPD in hospital admissions The role of antibiotics in acute exacerbations of chronic obstructive pulmonary disease (COPD) is controversial and a biomarker identifying patients who benefit from antibiotics is mandatory. We performed a randomised, controlled trial in patients with acute exacerbations of COPD, comparing C-reactive protein (CRP)-guided antibiotic treatment to patient reported symptoms in accordance with the Global (...) Initiative for Chronic Obstructive Lung Disease (GOLD) strategy, in order to show a reduction in antibiotic prescription.Patients hospitalised with acute exacerbations of COPD were randomised to receive antibiotics based either on the GOLD strategy or according to the CRP strategy (CRP ≥50 mg·L-1).In total, 101 patients were randomised to the CRP group and 119 to the GOLD group. Fewer patients in the CRP group were treated with antibiotics compared to the GOLD group (31.7% versus 46.2%, p=0.028; adjusted

2019 EvidenceUpdates

69. Are Antibiotics Effective in the Treatment of Children With Prolonged Wet Cough? Full Text available with Trip Pro

Are Antibiotics Effective in the Treatment of Children With Prolonged Wet Cough? Are Antibiotics Effective in the Treatment of Children With Prolonged Wet Cough? - Annals of Emergency Medicine Email/Username: Password: Remember me Search Terms Search within Search Share this page Access provided by Volume 73, Issue 5, Pages 453–455 Are Antibiotics Effective in the Treatment of Children With Prolonged Wet Cough? x Brit Long , MD (EBEM Commentator) , x Michael D. April , MD, DPhil (EBEM (...) Commentator) Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, Fort Sam Houston, TX DOI: | Publication History Published online: November 13, 2018 Expand all Collapse all Article Outline Take-Home Message Antibiotics may improve clinical cure and reduce progression of illness in children with prolonged wet cough. Methods Data Sources Authors identified trials from the Cochrane Airways Trials Register, CENTRAL, MEDLINE OvidSP, and EMBASE OvidSP through September

2019 Annals of Emergency Medicine Systematic Review Snapshots

70. FSRH CEU statement on antibiotic cover for urgent insertion of intrauterine contraception in women at high risk of STI

FSRH CEU statement on antibiotic cover for urgent insertion of intrauterine contraception in women at high risk of STI FSRH CEU statement on antibiotic cover for urgent insertion of intrauterine contraception in women at high risk of STI (May 2019) - Faculty of Sexual and Reproductive Healthcare FSRH CEU statement on antibiotic cover for urgent insertion of intrauterine contraception in women at high risk of STI (May 2019) FSRH CEU statement on antibiotic cover for urgent insertion (...) of intrauterine contraception in women at high risk of STI (May 2019) Share this article Published on: 22 May 2019 File size: 241kb PDF File type: Clinical Statements This statement provides guidance on antibiotic cover for urgent insertion of intrauterine contraception in women at high risk of STI. Download the full document here. Your download should start automatically. If not . Document types Thinking about taking a qualification? Registration is now quick and easy online. About FSRH FSRH is a faculty

2019 Faculty of Sexual & Reproductive Healthcare

71. Antimicrobial resistance (AMR): applying All Our Health

prevent ill health and promote wellbeing as part of their everyday practice. The information below will help front-line health and care staff use their trusted relationships with patients, families and communities to promote the benefits of preventing antimicrobial resistance ( of ‘All Our Health’ topics. Infections that cannot be treated continue to develop. The rapid spread of multidrug resistant organisms means that we may not be able to treat everyday infections or diseases with antibiotics (...) in the near future. Many existing antimicrobials are becoming less effective as bacteria, viruses, protozoa and fungi are adapting and becoming resistant to medicines. Inappropriate use of these valuable medicines has also added to the problem. Without effective antibiotics, even minor surgery and routine operations could become high risk procedures if serious infections can’t be treated. Access the antimicrobial resistance e-learning session An is now available to use. and 5 Year Action Plan set out

2019 Public Health England

72. Antibiotic use for irreversible pulpitis. (Abstract)

Antibiotic use for irreversible pulpitis. Irreversible pulpitis, which is characterised by acute and intense pain, is one of the most frequent reasons that patients attend for emergency dental care. Apart from removal of the tooth, the customary way of relieving the pain of irreversible pulpitis is by drilling into the tooth, removing the inflamed pulp (nerve) and cleaning the root canal. However, a significant number of dentists continue to prescribe antibiotics to stop the pain (...) of irreversible pulpitis.This review updates the previous version published in 2016.To assess the effects of systemic antibiotics for irreversible pulpitis.We searched Cochrane Oral Health's Trials Register (to 18 February 2019); the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 1) in the Cochrane Library (searched 18 February 2019); MEDLINE Ovid (1946 to 18 February 2019); Embase Ovid (1980 to 18 February 2019); US National Institutes of Health Ongoing Trials Register

2019 Cochrane

73. Antibiotic therapy for adults with neurosyphilis. (Abstract)

Antibiotic therapy for adults with neurosyphilis. Neurosyphilis is an infection of the central nervous system, caused by Treponema pallidum, a spirochete capable of infecting almost any organ or tissue in the body causing neurological complications due to the infection. This disease is a tertiary manifestation of syphilis. The first-line treatment for neurosyphilis is aqueous crystalline penicillin. However, in cases such as penicillin allergy, other regimes of antibiotic therapy can be used.To (...) assess the clinical effectiveness and safety of antibiotic therapy for adults with neurosyphilis.We searched the Cochrane Library, CENTRAL, MEDLINE, Embase, LILACS, World Health Organization International Clinical Trials Registry Platform and Opengrey up to April 2019. We also searched proceedings of eight congresses to a maximum of 10 years, and we contacted trial authors for additional information.We included randomised clinical trials that included men and women, regardless of age, with definitive

2019 Cochrane

74. Head-to-head oral prophylactic antibiotic therapy for chronic obstructive pulmonary disease. (Abstract)

Head-to-head oral prophylactic antibiotic therapy for chronic obstructive pulmonary disease. Chronic obstructive pulmonary disease (COPD; including chronic bronchitis and emphysema) is a chronic respiratory condition characterised by shortness of breath, cough and recurrent exacerbations. Long-term antibiotic use may reduce both bacterial load and inflammation in the airways. Studies have shown a reduction of exacerbations with antibiotics in comparison to placebo in people with COPD (...) , but there are concerns about antibiotic resistance and safety.To compare the safety and efficacy of different classes of antibiotics (continuous, intermittent or pulsed) for prophylaxis of exacerbations in patients with COPD.We searched the Cochrane Airways Group Trials Register and bibliographies of relevant studies. The latest literature search was conducted on 6 February 2019.Randomised controlled trials (RCTs) were selected that compared one prophylactic antibiotic with another in patients with COPD.We used

2019 Cochrane

75. Two weeks versus four weeks of antibiotic therapy after surgical drainage for native joint bacterial arthritis: a prospective, randomised, non-inferiority trial Full Text available with Trip Pro

Two weeks versus four weeks of antibiotic therapy after surgical drainage for native joint bacterial arthritis: a prospective, randomised, non-inferiority trial The optimal duration of postsurgical antibiotic therapy for adult native joint bacterial arthritis remains unknown.We conducted a prospective, unblinded, randomised, non-inferiority study comparing either 2 or 4 weeks of antibiotic therapy after surgical drainage of native joint bacterial arthritis in adults. Excluded were implant (...) -related infections, episodes without surgical lavage and episodes with a follow-up of less than 2 months.We enrolled 154 cases: 77 in the 4-week arm and 77 in the 2-week arm. Median length of intravenous antibiotic treatment was 1 and 2 days, respectively. The median number of surgical lavages was 1 in both arms. Recurrence of infection was noted in three patients (2%): 1 in the 2-week arm (99% cure rate) and 2 in the 4-week arm (97% cure rate). There was no difference in the number of adverse events

2019 EvidenceUpdates

76. HTA of C-reactive protein point-of-care testing to guide antibiotic prescribing

a range of health services, in conjunction with the Department of Health and the HSE. Health Technology Assessment (HTA) of CRP POCT Health Information and Quality Authority iv Foreword Antimicrobial resistance occurs when bacteria adapt in response to the use of medicines. When bacteria become antibiotic resistant, infections become more difficult to manage and treat. Antimicrobial resistance is a significant threat to public health, and widely acknowledged to be associated with the excessive (...) , but not for those with acute bronchitis. ? Overprescribing of antibiotics for RTIs in primary care is common in most industrialised countries, with high levels of inappropriate prescribing documented. Antibiotic treatment of RTIs can expose patients to an increased risk of an adverse event, with one out of five patients experiencing mostly minor and self-limiting adverse events. Antimicrobial resistance (AMR) is a growing and significant threat to public health, and it is widely recognised that antibiotic

2019 Health Information and Quality Authority

77. The Collaborative Assessment, OTCA12, on “C-reactive protein point-of-care testing (CRP POCT) to guide antibiotic prescribing in primary care settings for acute respiratory tract infections (RTIs)

-reactive protein point-of-care testing to guide antibiotic prescribing for acute respiratory tract infections in primary care EUnetHTA Joint Action 3 WP4 3 Consultation of the draft Rapid Assessment External experts [V.1.3] Elizabeth Beech, National Project Lead – Healthcare Acquired Infection and Antimicrobial Resistance, NHS Improvement, England Dr Nuala O’Connor, Irish College of General Practitioners (ICGP) GP Lead HSE Clinical Programme HCAI-AMR Professor Martin Cormican, National Clinical Lead (...) ) RECOMMENDATIONS IN EUROPEAN COUNTRIES FOR CRP POCT 248 Figures FIGURE 1: ANATOMY OF THE RESPIRATORY TRACT 67 FIGURE 2: ANTIMICROBIAL RESISTANCE (COMBINED NON-SUSCEPTIBILITY FOR PENICILLINS AND MACROLIDES) VERSUS STREPTOCOCCUS PNEUMONIAE IN EU/EEA COUNTRIES, 2017 68 FIGURE 3: CONSUMPTION OF ANTIBIOTICS FOR SYSTEMIC USE IN THE COMMUNITY, EU/EEA COUNTRIES, 2016 (EXPRESSED AS DDD PER 1 000 INHABITANTS PER DAY) 69 FIGURE 4: FLOW CHART SYSTEMATIC REVIEW 1 (EFFECTIVENESS AND SAFETY) 83 C-reactive protein point

2019 EUnetHTA

78. Fluoroquinolone antibiotics: new restrictions and precautions for use due to very rare reports of disabling and potentially long-lasting or irreversible side effects

and tendon rupture report suspected adverse drug reactions to fluoroquinolone antibiotics on the or via the Yellow Card app (download it from the , or ) New restricted indications Fluoroquinolones are antibiotics authorised for serious, life-threatening bacterial infections. As for all antibiotic medicines, consideration should be given to official guidance on the appropriate use of antibacterial agents (see section below on Prescribing guidance). Following an EU-wide review of safety, new restricted (...) Fluoroquinolone antibiotics: new restrictions and precautions for use due to very rare reports of disabling and potentially long-lasting or irreversible side effects Fluoroquinolone antibiotics: new restrictions and precautions for use due to very rare reports of disabling and potentially long-lasting or irreversible side effects - GOV.UK GOV.UK uses cookies to make the site simpler. or Search Fluoroquinolone antibiotics: new restrictions and precautions for use due to very rare reports

2019 MHRA Drug Safety Update

79. Proposals for a more effective antibiotic policy in Belgium

(BAPCOC) 24 1.1.6 Difficult to obtain significant improvements 24 1.2 RESEARCH QUESTIONS & SCOPE 25 1.3 TERMINOLOGY 25 1.4 METHODOLOGY 26 1.5 STRUCTURE OF THE REPORT 26 2 ANTIBIOTIC USE AND ITS LINK WITH ANTIBACTERIAL RESISTANCE 27 2.1 WHAT IS ANTIMICROBIAL RESISTANCE? 27 2.1.1 Antibacterial resistance, a natural phenomenon 27 2.1.2 How do bacteria become resistant? 27 2.1.3 How does antibiotic resistance spread? 28 2.1.4 Multidrug resistant organisms 28 2.1.1 Resistance in community and healthcare (...) . This document is available on the website of the Belgian Health Care Knowledge Centre. KCE Report 311 Antibiotic policy in Belgium 1 ? TABLE OF CONTENTS LIST OF FIGURES 8 LIST OF TABLES 10 LIST OF ABBREVIATIONS 13 ? SCIENTIFIC REPORT 23 1 INTRODUCTION 23 1.1 SHORT DESCRIPTION OF THE PROBLEM 23 1.1.1 Antibiotic resistance 23 1.1.2 Antibiotic use in Belgium 24 1.1.3 The concept of prudent antimicrobial/antibiotic use 24 1.1.4 One Health approach 24 1.1.5 Belgian Antibiotic Policy Coordination Committee

2019 Belgian Health Care Knowledge Centre

80. Effect of prolonged antibiotic treatment on cognition in patients with Lyme borreliosis Full Text available with Trip Pro

Effect of prolonged antibiotic treatment on cognition in patients with Lyme borreliosis To investigate whether longer-term antibiotic treatment improves cognitive performance in patients with persistent symptoms attributed to Lyme borreliosis.Data were collected during the Persistent Lyme Empiric Antibiotic Study Europe (PLEASE) trial, a randomized, placebo-controlled study. Study participants passed performance-validity testing (measure for detecting suboptimal effort) and had persistent (...) treatment with ceftriaxone followed by a 12-week regimen of doxycycline or clarithromycin/hydroxychloroquine did not lead to better cognitive performance compared to a 2-week regimen of ceftriaxone in patients with Lyme disease-attributed persistent symptoms.NCT01207739.This study provides Class II evidence that longer-term antibiotics in patients with borreliosis-attributed persistent symptoms does not increase cognitive performance compared to shorter-term antibiotics.Copyright © 2019 The Author(s

2019 EvidenceUpdates