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1741. Review: silver alloy catheters are more effective than standard catheters for reducing bacteriuria in adults in hospital having short term catheterisation Full Text available with Trip Pro

parallel group RCTs [4237 patients] and 1 cluster randomised crossover trial [27 878 patients]) met the selection criteria. 11 trials compared antiseptic impregnated catheters with standard catheters, 1 trial compared antibiotic impregnated catheters with standard catheters, and 6 trials compared different standard catheters. 2 types of antiseptic catheters (silver alloy and silver oxide) were compared with a standard catheter. Silver alloy catheters reduced rates of asymptomatic bacteriuria compared (...) catheters reduced asymptomatic or symptomatic bacteriuria more than standard catheters; silver oxide catheters did not differ from standard catheters. Insufficient evidence exists on whether catheters impregnated with antibiotics or antiseptics reduce infection . Commentary Urinary tract infection is the most common hospital acquired infection, and is often associated with urinary catheters. It is a concern for all nurses. Brosnahan et al did a systematic review of existing research on the influence

2005 Evidence-Based Nursing

1742. Mupirocin reduces infections in Staphylococcus aureus carriers

groups of patients. Local antibiotic treatment with mupirocin ointment is often used to eradicate S. aureus. Until now, routine use of mupirocin has not been applied in many hospitals, mainly due to concern about the development of mupirocin resistance and the absence of convincing evidence that it reduces the infection rate. Cochrane Systematic Review Van Rijen M et al. Mupirocin ointment for preventing Staphylococcus aureus infections in nasal carriers. Cochrane Reviews 2008, Issue 4. Article

2008 Publication 410

1743. Prevention and Treatment of Influenza A and B

of efficacy is based on all trial participants. In pooled data from 2 RCTs zanamivir reduced the primary outcome by a median of 0.9 days , and oseltamivir by 0.8 days. , Symptom severity was not significantly different between zanamivir and placebo. Symptom severity was not adequately reported apart from duration for oseltamivir. , No significant difference was seen in use of acetaminophen, cough syrup or antibiotics with either drug versus placebo. Serious complications leading to hospitalization

2000 Therapeutics Letter

1744. New Drugs VI ? Rosiglitazone (Avandia®), Tolterodine (Detrol®), Bupropion (Wellbutrin SR®, Zyban®), Doxazosin (Cardura®)

. Long term compliance is poor, even in a trial setting. Gatifloxacin (Tequin ® ) and Moxifloxacin (Avelox ® ) Approved indications for both: “acute sinusitis, community-acquired pneumonia (CAP) and acute exacerbation of chronic bronchitis (AECB). Additional indications for gatifloxacin are uncomplicated and complicated UTI, pyelonephritis and uncomplicated gonorrhoea.” Mechanism of action: Similar to other fluroquinolone antibiotics. Pharmacokinetics: Both are well absorbed with half-lives of 12 (...) hours. Gatifloxacin is eliminated by the kidney and moxifloxacin is metabolized by the liver. Evidence of effectiveness: Gatifloxacin has been compared with other antibiotics in 9 double blind RCTs. Eight of these trials show clinical efficacy ranging from 88 to 98%, which was not different from levofloxacin, ofloxacin, clarithromycin and erythromycin in the treatment of acute sinusitis, CAP, AECB, UTI and gonorrhoea. In one trial, gatifloxacin was significantly more effective than cefuroxime axetil

2000 Therapeutics Letter

1745. Asymptomatic Bacteriuria in Pregnancy: Rapid answers using the Cochrane Library

confirm that she has no urinary symptoms. You remember that she should probably be treated with an antibiotic, but when you suggest this, she says she does not want to expose her fetus to any drugs unless it is absolutely necessary. In fact, she asks you, “Why do I need to take an antibiotic and what is the potential harm?” She also asks if cranberry juice would suffice. In order to buy some time, you suggest she repeat the urine culture and arrange to see her in one week at which time you promise (...) in the Cochrane Database of Systematic Reviews, 9 complete reviews and 5 protocols (reviews in progress). When you double click on the reviews, you find 5 titles that are possibly relevant to this case: 1) Antibiotics for asymptomatic bacteriuria in pregnancy, 2) Duration of treatment for asymptomatic bacteriuria in pregnancy, 3) Treatment for symptomatic urinary tract infections during pregnancy, 4) Cranberries for treating urinary tract infections, and 5) Cranberries for preventing urinary tract infections

2001 Therapeutics Letter

1746. Do Single Stereoisomer Drugs Provide Value?

, it can be remarketed as a single enantiomer under a new patent. Are single enantiomers better? a) Esomeprazole (Nexium ® ) Esomeprazole (Nexium ® ), licensed in 2001, is the S-enantiomer of racemic S,R-omeprazole (Losec ® , Prilosec ® in the US). Approved Indications: Reduction of gastric acid secretion including reflux esophagitis, gastroesophageal reflux disease and in combination with antibiotics for eradication of H. pylori associated with peptic ulcer disease. Alternative proton pump inhibitors (...) ), licensed in 1998, is the pure L-form of the racemic mixture, ofloxacin (see ). The L-form contains the antimicrobial activity; the D-form is pharmacologically inert. Brand name racemic ofloxacin (Floxin ® , same manufacturer) was similarly priced, offering no cost advantage. Generic ofloxacin is now available and less expensive at comparable doses (800 mg ofloxacin contains 400 mg levofloxacin) (see ). Since once-daily levofloxacin has been proven effective, ofloxacin could be prescribed similarly

2002 Therapeutics Letter

1747. Do Statins have a Role in Primary Prevention?

drugs without assistance often deprive themselves of needed therapy due to cost. It’s for this reason that I am virulently opposed to a National Drug Plan! Canadians have become too complacent about medical costs and the addition of such a plan would undoubtedly break the bank. We need much more in the way of patient education in order to reduce our unnecessary pharmaceutical costs. You wouldn’t believe the number of times I have had a mother in the ER at night demanding an antibiotic

2003 Therapeutics Letter

1748. Do ophthalmic nonsteroidal anti-inflammatory drugs reduce the pain associated with simple corneal abrasion without delaying healing?

(proparacaine hydrochloride 0.5% solution), 2 drops of a topical antibiotic (gentamicin 0.3% solution), and either diclofenac or the control vehicle. Some patients also received 1 drop of a cycloplegic (cyclopentolate) at the discretion of the treating physician. Patients were discharged with a masked bottle of either diclofenac or the control vehicle (Natural Tears), with instructions to instill 1 drop every 6 hours while awake for 24 to 36 hours. Patients also received a bottle of topical gentamycin

2003 Evidence-Based Emergency Medicine

1749. Pre-hospital administration of antibiotics by paramedics for suspected cases of meningococcal disease

Pre-hospital administration of antibiotics by paramedics for suspected cases of meningococcal disease National Horizon Scanning Unit Horizon scanning prioritising summary Volume 14, Number 6: Pre-hospital administration of antibiotics by paramedics for suspected cases of meningococcal disease September 2006 © Commonwealth of Australia 2006 [add ISSN] [add Publications Approval Number] This work is copyright. You may download, display, print and reproduce this material in unaltered form only (...) summary was prepared by Linda Mundy and Tracy Merlin from the National Horizon Scanning Unit, Adelaide Health Technology Assessment, Discipline of Public Health, Mail Drop 511, University of Adelaide, South Australia, 5005. PRIORITISING SUMMARY REGISTER ID: 000229 NAME OF TECHNOLOGY: PRE-HOSPITAL ADMINISTRATION OF ANTIBIOTICS BY PARAMEDICS PURPOSE AND TARGET GROUP: FOR SUSPECTED CASES OF MENINGOCOCCAL INFECTION STAGE OF DEVELOPMENT (IN AUSTRALIA): Yet to emerge Established Experimental ? Established

2006 Australia and New Zealand Horizon Scanning Network

1750. Risk of Hemolytic Uremic Syndrome After Antibiotic Treatment of Escherichia coli O157:H7 Enteritis. A Meta-analysis

Risk of Hemolytic Uremic Syndrome After Antibiotic Treatment of Escherichia coli O157:H7 Enteritis. A Meta-analysis PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2008 PedsCCM Evidence-Based Journal Club

1751. Mad CAP Antics: Antibiotics Within 4 Hours

Mad CAP Antics: Antibiotics Within 4 Hours Mad CAP Antics: Antibiotics Within 4 Hours « Sinai EM Journal Club Emergency Medicine Discussion Forum Mad CAP Antics: Antibiotics Within 4 Hours Jack tackled a controversial topic at this month’s Journal Club — what’s the evidence for giving antibiotics within four hours for CAP patients? It’s a good question, because how well we perform at this task is a big part of how our hospitals are measured. Ineed, pneumonia antibiotic timing is one of JCAHO’s (...) to administration of antibiotics, this study can’t ethically be done prospectively. Their retrospective sample is worth noting, however: They took their numbers from a database of Medicare (over 65) with a primary or secondary ICD-9 code of pneumonia sampled from July 1- Dec 31, 1998, or Sept 1, 1998-March 31, 1999 (this database had 346,105 patients, though it seems possible they sampled the same patients twice). The authors randomly selected up to 850 cases from each state (more like the Senate than the House

2007 Sinai EM Journal Club

1752. No clear evidence of benefit for antimicrobial interventions in atopic eczema

were trialled - oral antibiotics, antibacterial soaps, topical steroids combined with antibacterials, antibacterial bath additives, topical antiseptic/antibiotic creams and silver- impregnated textiles. None of the trials showed any clear benefit in terms of short term eczema control, although several interventions were associated with decreased numbers of SA on the skin.There was no clear evidence that widely-used topical steroid/antibiotic combinations were better than use of the topical steroid (...) No clear evidence of benefit for antimicrobial interventions in atopic eczema PEARLS Practical Evidence About Real Life Situations PEARLS are succinct summaries of Cochrane Systematic Reviews for primary care practitioners. They No clear evidence of benefit for antimicrobial interventions in atopic eczema Clinical question How effective are interventions to reduce Staphylococcus aureus (SA) in treating infected or non-infected atopic eczema? Bottom line A range of anti-staphylococcal treatments

2008 Publication 410

1753. Prevention of nosocomial bloodstream infections: effectiveness of antimicrobial-impregnated and heparin-bonded central venous catheters

Prevention of nosocomial bloodstream infections: effectiveness of antimicrobial-impregnated and heparin-bonded central venous catheters PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2000 PedsCCM Evidence-Based Journal Club

1754. A comparison of two antimicrobial-impregnated central venous catheters.

A comparison of two antimicrobial-impregnated central venous catheters. PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

1999 PedsCCM Evidence-Based Journal Club

1755. Does the Overuse of Macrolides Lead to Antibiotic Resistance?

Does the Overuse of Macrolides Lead to Antibiotic Resistance? Does the Overuse of Macrolides Lead to Antibiotic Resistance? – Clinical Correlations Search Does the Overuse of Macrolides Lead to Antibiotic Resistance? March 12, 2007 3 min read Commentary By: Danise Schiliro, PGY-3 Although intuitively we always worry about creating drug resistance when using antibiotics, there is a surprising lack of well done studies that show a clear causal effect of antibiotic use on the development (...) of macrolide-resistant streptococci. Oral streptococcal flora harbors the same macrolide resistance genes seen in pathogenic streptococci; therefore, the results obtained from healthy subjects should be applicable to the patients we treat for streptococcal respiratory infections. The results showed that a single course of either antibiotic caused an increase in macrolide-resistant streptococci compared with placebo, and this effect lasted for the entire duration of the study. Because the study was stopped

2007 Clinical Correlations

1756. A probiotic drink prevented diarrhoea and Clostridium difficile infection in older patients taking antibiotics

A probiotic drink prevented diarrhoea and Clostridium difficile infection in older patients taking antibiotics A probiotic drink prevented diarrhoea and Clostridium difficile infection in older patients taking antibiotics | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using your username (...) and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here A probiotic drink prevented diarrhoea and Clostridium difficile infection in older patients taking antibiotics Article Text Therapeutics A probiotic drink prevented

2008 Evidence-Based Medicine

1757. Review: delayed or immediate prescriptions of antibiotics have similar clinical outcomes in respiratory infections

Review: delayed or immediate prescriptions of antibiotics have similar clinical outcomes in respiratory infections Review: delayed or immediate prescriptions of antibiotics have similar clinical outcomes in respiratory infections | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using your username (...) and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Review: delayed or immediate prescriptions of antibiotics have similar clinical outcomes in respiratory infections Article Text Therapeutics Review: delayed

2008 Evidence-Based Medicine

1758. Review: children <2 years of age with bilateral acute otitis media and children with otorrhoea benefit most from antibiotics

Review: children <2 years of age with bilateral acute otitis media and children with otorrhoea benefit most from antibiotics Review: children | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using your username and password For personal accounts OR managers of institutional accounts Username (...) * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Review: children Article Text Therapeutics Review: children <2 years of age with bilateral acute otitis media and children with otorrhoea benefit most from antibiotics Statistics from Altmetric.com Request Permissions If you wish to reuse any

2008 Evidence-Based Medicine

1759. Review: antibiotic therapy leads to slightly earlier recovery in acute bacterial conjunctivitis

Review: antibiotic therapy leads to slightly earlier recovery in acute bacterial conjunctivitis Review: antibiotic therapy leads to slightly earlier recovery in acute bacterial conjunctivitis | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using your username and password For personal accounts (...) OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Review: antibiotic therapy leads to slightly earlier recovery in acute bacterial conjunctivitis Article Text Therapeutics Review: antibiotic therapy leads to slightly earlier recovery in acute

2006 Evidence-Based Medicine

1760. Antibiotics in cat bites

Antibiotics in cat bites BestBets: Antibiotics in cat bites Antibiotics in cat bites Report By: Tanzeem Iqbal - Medical Student Search checked by Dr Bernard Foex - A & E Consultant Institution: Manchester Royal Infirmary A & E Department Date Submitted: 5th July 2005 Last Modified: 14th October 2008 Status: Green (complete) Three Part Question In [patients with cat bite wounds] do [prophylactic antibiotics] reduce [the incidence of wound infection]? Clinical Scenario A 29 year old man presents (...) to the Emergency Department with a cat bite wound on left his arm. He says he was bitten some 6 hours prior to attendance. The wound is cleaned and it is noted that there are no signs of infection. You wonder whether prophylactic antibiotics are required to reduce the risk of wound infection. Search Strategy Ovid MEDLINE(R) 1950 to June Week 4 2008 and EMBASE 1980 to 2008 Week 27 using multifile searching The Cochrane Library Issue 2 2008 cat bite.mp. AND (wound infection.mp. or exp Wound Infection/ OR exp

2008 BestBETS

Evidence-based Synopses

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