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1501. Adenoidectomies decrease the pathogenic nasopharyngeal bacterial

to decrease after adenoidectomy but the carriage of nonpathogens increases. The methodological quality of the design was poor. Other factors may have biased the effect of adenoidectomy on the colonization of bacteria in the nasopharynx. For instance, the use of antibiotics was only reported in three publications. Also, the postoperative swabs were taken after a short period of time varying from 10 days to three months. There should be more long term data. Source of Funding: None Commentary Importance (...) and Context: It is important to know if a patient has a respiratory infection and/or is taking any antibiotics before starting dental treatment on a patient in order to determine the methods used for dental treatment. Strengths and Weaknesses of the Systematic Review: This low quality included a comprehensive literature search strategy, well defined inclusion/exclusion criteria . It also included a list of studies with its characteristics provided in a clear table format. The weakness

2011 ADA Center for Evidence-Based Dentistry

1502. Topical chlorhexidine may be useful in preventing dry socket.

and delivery systems? Review Methods: In December 2008, the authors searched three electronic databases for randomized and nonrandomized clinical trials that evaluated CHX at any concentration or delivery system. The authors excluded studies in which the same patient received both CHX and antibiotic interventions. For trials that lacked a placebo control, the authors used data from another that evaluated patients with similar characteristics. Main Results: The search produced 12 clinical trials

2011 ADA Center for Evidence-Based Dentistry

1503. Adenoidectomies decrease the pathogenic nasopharyngeal bacterial

to decrease after adenoidectomy but the carriage of nonpathogens increases. The methodological quality of the design was poor. Other factors may have biased the effect of adenoidectomy on the colonization of bacteria in the nasopharynx. For instance, the use of antibiotics was only reported in three publications. Also, the postoperative swabs were taken after a short period of time varying from 10 days to three months. There should be more long term data. Source of Funding: None Commentary Importance (...) and Context: It is important to know if a patient has a respiratory infection and/or is taking any antibiotics before starting dental treatment on a patient in order to determine the methods used for dental treatment. Strengths and Weaknesses of the Systematic Review: This low quality included a comprehensive literature search strategy, well defined inclusion/exclusion criteria . It also included a list of studies with its characteristics provided in a clear table format. The weakness

2011 ADA Center for Evidence-Based Dentistry

1504. Topical chlorhexidine may be useful in preventing dry socket.

and delivery systems? Review Methods: In December 2008, the authors searched three electronic databases for randomized and nonrandomized clinical trials that evaluated CHX at any concentration or delivery system. The authors excluded studies in which the same patient received both CHX and antibiotic interventions. For trials that lacked a placebo control, the authors used data from another that evaluated patients with similar characteristics. Main Results: The search produced 12 clinical trials

2011 ADA Center for Evidence-Based Dentistry

1505. Tigecycline (Tygacil?): increased mortality in clinical trials

with patients treated with other antibacterial agents patients who develop superinfections, particularly nosocomial pneumonia, seem to be at particular risk of having a poor outcome - patients should be closely monitored for the development of superinfections; if medically indicated, they should be switched to alternative antibiotic treatment which has been shown to be efficacious in the treatment of the specific infection present report suspected adverse reactions with tigecycline through the Yellow Card (...) Tigecycline (Tygacil?): increased mortality in clinical trials Tigecycline (Tygacil▼): increased mortality in clinical trials - GOV.UK GOV.UK uses cookies to make the site simpler. or Search Tigecycline (Tygacil▼): increased mortality in clinical trials Use only when other antibiotics are unsuitable Published 11 December 2014 From: Therapeutic area: Contents Article date: April 2011 Tigecycline is a glycylcycline antibiotic approved for the treatment of complicated skin and soft tissue

2011 MHRA Drug Safety Update

1506. Moxifloxacin: increased risk of life-threatening liver reactions and other serious risks

: January 2011 Because of evidence of an increased risk of life-threatening liver reactions and other serious risks (such as QT interval prolongation), oral moxifloxacin (Avelox ▼, a fluoroquinolone antibiotic) should be used only when it is considered inappropriate to use antibacterial agents that are commonly recommended for the initial treatment of the infections below or when these have failed. This restriction now applies to treatment of mild to moderate pelvic inflammatory disease as well (...) Moxifloxacin: increased risk of life-threatening liver reactions and other serious risks Moxifloxacin: increased risk of life-threatening liver reactions and other serious risks - GOV.UK GOV.UK uses cookies to make the site simpler. or Search Moxifloxacin: increased risk of life-threatening liver reactions and other serious risks Use in pelvic inflammatory disease only when other antibacterials are inappropriate or ineffective. Published 11 December 2014 From: Therapeutic area: Article date

2011 MHRA Drug Safety Update

1507. Citalopram and escitalopram: QT interval prolongation

of citalopram and escitalopram with medicines that prolong the QT interval is therefore contraindicated. These include: class IA and III antiarrhythmics (eg, amiodarone, dronedarone, quinidine) antipsychotics (eg, phenothiazine derivatives, pimozide, haloperidol) tricyclic antidepressants some antimicrobial agents (eg, sparfloxacin, moxifloxacin, erythromycin IV, pentamidine, antimalaria treatment—particularly halofantrine) some antihistamines (astemizole, mizolastine) some antiretrovirals (eg, ritonavir

2011 MHRA Drug Safety Update

1508. The MIST Therapy system for the promotion of wound healing

a week. No antiseptics, antibiotics, silver or antimicrobial dressings were used during the study. The study reported that the mean wound bioburden decreased by 50% (from 4 x 10 7 to 2 x 10 7 colony-forming units per gram of tissue) during treatment. Mean wound area decreased by 26% and mean wound volume decreased by 20% during the treatment period. Committee considerations 3.13 The Committee considered that the evidence suggested real potential for the MIST Therapy system to enhance the healing (...) the healing time of these wounds it could potentially offer substantial cost savings to the NHS, although most chronic wounds are likely to involve less prolonged and complex treatment. 4.2 The MIST Therapy system is claimed to enhance healing and decrease bioburden in wounds and might therefore reduce the use of antimicrobial dressings and systemic antibiotics. This could result in a reduction in the expenditure on wound dressings and in the risk of antibiotic resistance. 4.3 The Committee was advised

2011 National Institute for Health and Clinical Excellence - Medical technologies

1509. Randomised controlled trial: Two weeks of rifaximin relieves global symptoms and bloating in people with IBS without constipation

-specific antibiotic, rifaximin, may be well suited to treat SIBO in IBS. Methods The TARGET study combines data from a pair of large, well-designed, phase III registration trials in 1260 IBS patients with mild-to-moderate, non-constipating symptoms. Patients were randomised to receive either rifaximin, 550 mg three times daily for 2 weeks, or placebo. There was no effort to test for SIBO before treatment, which was initiated empirically. The main outcome measure was improvement in global IBS symptoms

2011 Evidence-Based Medicine

1510. Randomised controlled trial: Amoxicillin-clavulanate improves symptoms, reduces treatment failure in select children with acute otitis media and increases risk of diarrhoea

high rates of spontaneous resolution of symptoms, so that an estimated 7–17 children would need to be treated with antibiotics to improve one child's clinical outcomes. However, limitations of previous trials, including variability in diagnostic criteria, participants' ages and antimicrobial and supportive treatments used, have kept the debate alive. 2 , – , 4 Two recent randomised trials by Hoberman and colleagues and Tahtinen and colleagues have addressed the benefit of antibiotics in young (...) children with acute otitis media and increases risk of diarrhoea Article Text Therapeutics Randomised controlled trial Amoxicillin-clavulanate improves symptoms, reduces treatment failure in select children with acute otitis media and increases risk of diarrhoea Andrea Marmor 1 , Thomas B Newman 1 Statistics from Altmetric.com Commentary on: Tähtinen PA , Laine MK , Huovinen P , et al . A placebo-controlled trial of antimicrobial treatment for acute otitis media . Commentary on: Hoberman A , Paradise

2011 Evidence-Based Medicine

1511. Pretending that evidence is difficult and complicated

signed in June last year. I can barely remember what it was about (well, obviously it was critical of homeopathy) but the response is predictably woolly. A nice touch though is that the summary page links to the ‘full response’ which turns out to be a 1998 document on ‘resistance to antibiotics and other antimicrobial agents’ said, February 19, 2011 at Thank you for writing this post. Reading this blog makes me feel like I’m not the only one who gets fed up with quacks, quack medicine, lack (...) otherwise require drugs which would have serious side effects? I appreciate that if people use these pills in cases where they really need chemotherapy or antibiotics, that’s a bit of a disaster, but if they have a condition where they can use a cheap placebo with no side effects and feel genuinely better able to enjoy life as a result, then changing labelling so that the pill no longer works does seem a bit counterproductive. Guy said, February 21, 2011 at Emmy, you says pets won’t get better, well

2011 Bad Science

1512. Steroids for Croup

Steroids for Croup Steroids for Croup – TheNNTTheNNT Glucocorticoids (Steroids) for Croup 5 for respiratory improvement In Summary, for those who received the steroids: Benefits in NNT 80% saw no benefit 20% were helped by respiratory improvement 9.2% were helped by avoiding a return visit 1 in 5 were helped (respiratory improvement) 1 in 11 were helped (avoiding a return visit) Harms in NNT 0% were harmed None were harmed (need for rescue therapy intubation/tracheostomy, antibiotic use (...) the need for rescue therapy, such as intubation/tracheostomy, antibiotic use, additional glucocorticoid use, or mist tent use. While there was no reduction in these rescue therapy endpoints, a reduction in epinephrine as a rescue therapy was noted, with an absolute risk reduction of 10% (NNT = 10). Caveats: In the Cochrane review, glucocorticoid has been shown to reduce the revisits and/or (re)admission rates and to decrease epinephrine use as a rescue therapy. The seven trials in the ED show the most

2011 theNNT

1513. Alpha-blockers increase the chances of a successful trial without catheter

for surgery and 15 were designated to be a UTI rather than BPH, so only given antibiotics, but often retrospectively found to have more evidence for the other diagnosis or even both. Lo et al, 2010, Hong Kong 248 patients (mean age 71, range 50-93) presenting with 1st episode of AUR secondary to BPH & who could void successfully after initial TWOC following treatment with alpha-blocker over a 4-year period. 19 (7.7%) given Terazosin, 214 (86.3%) given Doxazosin, 15 (6.0%) given Doxazosin gastrointestinal

2011 BestBETS

1514. Azithromycin ophthalmic solution (Azidrop®) for purulent bacterial or trachomal conjunctivitis

or trachomal conjunctivitis Content tools Share it Similar efficacy at a higher cost Azithromycin in topical ophthalmic form is indicated in the treatment of susceptible strains of bacterial conjunctivitis and trachoma related conjunctivitis caused by Chlamydia trachomatis. The majority of purulent bacterial conjunctivitis cure spontaneously, and azithromycin has shown a similar efficacy and safety profile to tobramycin. There are no trials comparing other antibiotics. Although its posology is much more

2011 Drug and Therapeutics Bulletin of Navarre (Spain)

1515. Does Culturing the Catheter Tip Change Patient Outcomes?

jugular vein. A chest x-ray showed a right lower lobe infiltrate and he is treated empirically with antibiotics for pneumonia. Blood cultures grow out S. pneumoniae. After four days he is successfully extubated. The night following extubation, the patient has a fever of 100.8 without hemodynamic instability. Peripheral blood cultures are drawn and his central venous catheter is removed. The next morning, during rounds, a debate ensues regarding whether the catheter tip should also have been sent (...) . The authors assessed whether results prompted a change in, or the initiation of, an antibiotic regimen. While the authors determined that 4% of catheter culture results led to changes in patient management, the clinical significance of these results were found to be “questionable or even misleading.” The authors concluded that management of catheter infection was driven primarily by peripheral blood culture results and that catheter .[10] In a 2009 publication, a retrospective analysis of 120 septic

2011 Clinical Correlations

1516. Medicine By Numbers: 131 Million

of beta blockers prescribed was greater than what appears on the list. Another surprise (or not) is the seventh and eighth most popular drugs, azithromycin and amoxicillin. For medications that should only be used intermittently and not on a daily basis, the number of prescriptions is staggering. There is good evidence from a May 2010 systematic review article with meta-analysis in the British Medical Journal which showed the development of antimicrobial resistance in patients prescribed antibiotics (...) of antimicrobial resistance from indiscriminate or poor utilization of antibiotics requires thoughtful intervention. Dr. Maryann Kwa is a 3rd year resident at NYU Langone Medical Center Peer reviewed by Neil Shapiro, MD, Editor-In-Chief, Clinical Correlations References: [1] IMS Institute for Healthcare Informatics. The use of medicines in the United States: review of 2010. IMS Health.com ; 2011 July 1. Available from: [2] Harris G. Ban is advised on 2 top pills for pain relief. The New York Times ; 2009 July

2011 Clinical Correlations

1517. Asking the wrong question: how crap research gets drugs to market

read will talk about the difficulties of applying findings from a study to an individual patient and will encourage clinicians to consider the individual needs of the patient when interpreting evidence. Far more of a problem is sensible guidelines being ignored. Common pitfalls include doctors prescribing too many antibiotics, parents refusing vaccinations for their children, ministers ignoring the advice of expert committees for political expediency, journals accepting articles that do not meet

2011 Bad Science

1518. Nonsurgical Endodontic Therapy Success in the HIV Positive Patient Population

underwent endodontic therapy. The HIV positive patient who presented with the complication (pain and swelling after initial endodontic therapy) received local debridement and antibiotic therapy and no further complications occurred. Weaknesses in the study included limited sample size, failure to regularly take into account important group characteristics like socio-economic status, and lack of total number of studies. Individual studies used were assessed for validity. Suchina JA et alStudy followed 54

2011 UTHSCSA Dental School CAT Library

1519. Analyzing The Effectiveness of Subacute Bacterial Endocarditis (SBE) Prophylaxes in Dentistry

Analyzing The Effectiveness of Subacute Bacterial Endocarditis (SBE) Prophylaxes in Dentistry UTCAT837, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Lack of Evidence for Effectiveness of Antibiotics for SBE Prophylaxes Prior to Invasive Dental Treatment Clinical Question In a patient with a history of heart murmur, how does the use of antibiotics compare to placebo with regards to SBE prophylaxes before an invasive (...) dental procedure? Clinical Bottom Line There was no difference between antibiotics VS placebo prophylaxis prior to invasive dental procedures in preventing SBE. (See Comments on the CAT below) Best Evidence (you may view more info by clicking on the PubMed ID link) PubMed ID Author / Year Patient Group Study type (level of evidence) #1) Worthington/2008 One case control study included Systematic Reveiw Key results This study included 349 patients in the Netherlands, who developed endocarditis

2011 UTHSCSA Dental School CAT Library

1520. Anti Fungal Medication Usage in Candida-Associated Denture Stomatitis

and/or STUDENTS COMMENTS ON PUBLISHED CATs) by Giang Tran DDS, Keaton Forrester, DMD (San Antonio, TX) on 11/13/2015 A PubMed & Trip Database search on this question in November, 2015 found more recent publication by Emami E et al 2014 ( PubMed ID ). This meta-analysis found from 233 articles, 14 RCTs were included in systematic review and 8 in the meta- analysis. This study concluded that disinfection agents, antiseptic mouthwashes, natural substances with antimicrobial properties, microwave disinfection

2011 UTHSCSA Dental School CAT Library

Evidence-based Synopses

Synopses are typically easily digested, critical commentaries of articles e.g. critically appraised topics.