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1. COVID-19 rapid guideline: antibiotics for pneumonia in adults in hospital

that bacterial co-infection occurs in less than about 10% of patients with COVID-19. But patients in critical care have an increased likelihood of bacterial infection compared with patients in other hospital wards or settings. • Because COVID-19 pneumonia is caused by a virus, antibiotics are ineffective unless there is a bacterial co-infection. • Inappropriate antibiotic use may reduce their availability, and indiscriminate use may lead to Clostridioides difficile infection and antimicrobial resistance (...) or more after admission and that was not incubating at admission). 3.5 When choosing antibiotics, take account of: • local antimicrobial resistance data and • other factors such as their availability. 3.6 For patients who are already taking an antibiotic that was started in the community for suspected pneumonia: • review the antibiotic choice and • change the antibiotic in line with antibiotic prescribing table 1, if appropriate. 3.7 Give oral antibiotics if the patient can take oral medicines

2020 National Institute for Health and Clinical Excellence - Clinical Guidelines

2. Diarrhoea - antibiotic associated: Scenario: Diarrhoea - antibiotic associated

in a NICE evidence summary on the risk of C. difficile with broad-spectrum antibiotics [ ], Public Health England diagnostic guidance [ ], and North American practice parameters [ ]. The most frequently implicated antibiotics include broad-spectrum penicillins, cephalosporins, clindamycin, and flouroquinolones, but most antibiotics have been associated with C. difficile infection [ ; ; ; ]. The risk of C. difficile infection is increased with greater number of antimicrobials used, higher doses (...) leading to toxic megacolon and intestinal perforation and necrosis [ ; ; ]. Antibiotics for treating mild to moderate Clostridium difficile infection The recommendations regarding the choice of antibiotic to treat C. difficile infection is based on guidance published by Public Health England: Updated guidance on the management and treatment of Clostridium difficile infection [ ], Managing suspected infectious diarrhoea [ ] and Summary of antimicrobial prescribing guidance - managing common infections

2019 NICE Clinical Knowledge Summaries

3. Antibiotics after incision and drainage for uncomplicated skin abscesses Full Text available with Trip Pro

of adverse effects including nausea and diarrhoea We suggest TMP-SMX rather than clindamycin because TMP-SMX has a lower risk of diarrhoea Cephalosporins in addition to incision and drainage are probably not more effective than incision and drainage alone in most settings From a societal perspective, the modest benefits from adjuvant antibiotics may not outweigh the harms from increased antimicrobial resistance in the community, although this is speculative Box 1 Linked articles in this BMJ Rapid (...) are likely to prefer TMP-SMX. Person-centred versus societal perspective (impact on antibiotic resistance) The recommendations explicitly take a person-centred perspective rather than a public health or societal perspective. The use of antibiotics is associated with the emergence of antibiotic resistance within the community and may increase the risk of antibiotic resistant infections in community members. The increasing rates of antimicrobial resistance are a public health priority. From a societal

2018 BMJ Rapid Recommendations

4. Respiratory tract infections (self-limiting) – reducing antibiotic prescribing

in the event of a significant clinical deterioration. Sore throat/pharyngitis/tonsillitis has been excluded from the contextualised guideline for two reasons: (i) in contrast to the UK, New Zealand has a relatively high incidence of rheumatic fever and therefore the risks of not prescribing an antibiotic treatment for many patients with sore throat are very much greater; and (ii) in New Zealand there are widely used guidelines that recommend antimicrobial treatment for patients with sore throat who (...) Otitis Media. Diagnosis and Management of Acute Otitis Media. Pediatrics, 2004 113(5), 1451-65. 2. McGregor A, Dovey S, Tilyard M. Antibiotic use in upper respiratory tract infections in New Zealand. Family Practice 1995;12:166-70. 3. Thomas MG, Smith AJ, Tilyard M. Rising antimicrobial resistance: a strong reason to reduce antimicrobial consumption in New Zealand. NZ Med J 2014;127:1394:72-84. 4. Heart Foundation of New Zealand: Guidelines for Group A Streptococcal Sore Throat Management Guideline

2019 Best Practice Advocacy Centre New Zealand

5. Antibiotic Stewardship in the Intensive Care Unit: An Official ATS Workshop Report in Collaboration with the ACCN, ACCP, CDC, and SCCM Full Text available with Trip Pro

for ASPs by intensivists ( – ), the philosophical approaches and priorities of critical care practitioners and ASPs can differ ( ). Although all involved desire the best patient outcomes, the potentially competing goals of adequate empirical antimicrobial therapy and antibiotic stewardship sometimes create tension. If stewardship efforts are to succeed, this conflict must be addressed. The goal of most critical care practitioners is rapid provision of the appropriate initial therapy. ASPs must work (...) . Tamma PD , Avdic E , Li DX , Dzintars K , Cosgrove SE . Association of adverse events with antibiotic use in hospitalized patients . JAMA Intern Med 2017 ;177: 1308 – 1315 . , , 31 . Hranjec T , Rosenberger LH , Swenson B , Metzger R , Flohr TR , Politano AD , et al . Aggressive versus conservative initiation of antimicrobial treatment in critically ill surgical patients with suspected intensive-care-unit-acquired infection: a quasi-experimental, before and after observational cohort study . Lancet

2020 American Thoracic Society

6. FSRH CEU Response to study: Analysis of reports of unintended pregnancies associated with the combined use of non-enzyme inducing antibiotics and hormonal contraceptives

FSRH CEU Response to study: Analysis of reports of unintended pregnancies associated with the combined use of non-enzyme inducing antibiotics and hormonal contraceptives 1 FSRH CEU Response to study: Analysis of reports of unintended pregnancies associated with the combined use of non-enzyme inducing antibiotics and hormonal contraceptives 19 August 2020 The BMJ Evidence Based Medicine Journal has published a paper 1 suggesting that antibiotics may lessen the effectiveness of hormonal (...) contraception. The authors used the ‘Yellow Cards’ system where clinicians and patients can report adverse drug side-effects to the UK’s drug and medical devices regulator, the Medicines and Healthcare products Regulatory Agency (MHRA). Data between 1963 and July 2018 was analysed and researchers compared the number of unintended pregnancies reported in 74,623 Yellow Cards for antibiotics in general and in 32,872 for enzyme-inducing drugs with those reported in 65,578 other types of drugs in users of oral

2020 Faculty of Sexual & Reproductive Healthcare

7. Diarrhoea - antibiotic associated

Diarrhoea - antibiotic associated Diarrhoea - antibiotic associated | Topics A to Z | CKS | NICE Search CKS… Menu Diarrhoea - antibiotic associated Diarrhoea - antibiotic associated Last revised in March 2019 Diarrhoea is a common consequence of treatment with antibiotics, occurring in 2–25% of people taking antibiotics Management Prescribing information Background information Diarrhoea - antibiotic associated: Summary Diarrhoea is a common consequence of treatment with antibiotics, occurring (...) in 2–25% of people taking antibiotics, depending on the antibiotic prescribed. Around 20% to 30% of cases of antibiotic-associated diarrhoea are due to Clostridium difficile . Antibiotics frequently associated with C. difficile infection include clindamycin, cephalosporins (especially third and fourth generation), fluoroquinolones, and broad-spectrum penicillins. Factors that increase the risk of C. difficile infection include increased age, history of C. difficile infection, exposure to other

2020 NICE Clinical Knowledge Summaries

8. Chronic obstructive pulmonary disease: Antibiotics

Chronic obstructive pulmonary disease: Antibiotics Antibiotics | Prescribing information | Chronic obstructive pulmonary disease | CKS | NICE Search CKS… Menu Antibiotics Chronic obstructive pulmonary disease: Antibiotics Last revised in November 2019 Antibiotics Azithromycin Contraindications and cautions Do not prescribe azithromycin in people: With severe hepatic impairment. Prescribe azithromycin with caution in people: Who may be predisposed to prolongation of the QT interval. For example (...) any muscle pain, tenderness, or weakness. Typhoid vaccine — antibacterials might reduce the immune response. The World Health Organization (WHO) recommends that the antibacterial is stopped from 3 days before to 3 days after receiving live oral typhoid vaccine. Warfarin — concurrent use may increase the international normalized ratio (INR). Consider increasing INR monitoring as this interaction appears to develop over the first 7 days. Drugs that prolong the QT interval (such as amiodarone

2020 NICE Clinical Knowledge Summaries

9. Antibiotic Use for the Urgent Management of Dental Pain and Intra-oral Swelling Clinical Practice Guideline Full Text available with Trip Pro

Centers for Disease Control and Prevention. Telebriefing on today's drug-resistant health threats. ( Available at: ) . , x 16 Centers for Disease Control and Prevention. Joint Statement on Importance of Outpatient Antibiotics Stewardship From 12 National Health Organizations. ( Available at: ) . , x 17 Centers for Disease Control and Prevention. Antibiotic/antimicrobial resistance (AR/AMR): the AMR challenge. ( Available at: ) . , x 18 White House Office of the Press Secretary. Fact sheet: over 150 (...) Antibiotic Use for the Urgent Management of Dental Pain and Intra-oral Swelling Clinical Practice Guideline Evidence-based clinical practice guideline on antibiotic use for the urgent management of pulpal- and periapical-related dental pain and intraoral swelling - The Journal of the American Dental Association Email/Username: Password: Remember me Search Terms Search within Search Access provided by Volume 150, Issue 11, Pages 906–921.e12 Evidence-based clinical practice guideline

2020 American Dental Association Guidelines

10. Antibiotic Prophylaxis in Gynaecologic Procedures

Antibiotic Prophylaxis in Gynaecologic Procedures No. 275-Antibiotic Prophylaxis in Gynaecologic Procedures - Journal of Obstetrics and Gynaecology Canada Email/Username: Password: Remember me Search Terms Search within Search Volume 40, Issue 10, Pages e723–e733 No. 275-Antibiotic Prophylaxis in Gynaecologic Procedures x Nancy Van Eyk , MD Halifax, NS x Julie van Schalkwyk , MD Vancouver, BC No. 275, April 2012 (Reaffirmed October 2018) DOI: To view the full text, please login as a subscribed (...) user or . Click to view the full text on ScienceDirect. Abstract Objective To review the evidence and provide recommendations on antibiotic prophylaxis for gynaecologic procedures. Outcomes Outcomes evaluated include need and effectiveness of antibiotics to prevent infections in gynaecologic procedures. Evidence Medline and The Cochrane Library were searched for articles published between January 1978 and January 2011 on the topic of antibiotic prophylaxis in gynaecologic procedures. Results were

2018 Society of Obstetricians and Gynaecologists of Canada

11. Is the use of chlorhexidine contributing to increased resistance to chlorhexidine and/or antibiotics?

’ defined by using the clinical breakpoints for resistance as specified by the European Committee on Antimicrobial Susceptibility testing (EUCAST) or the Clinical and Laboratory Standards Institute (CSLI). 2. Increase in the incidence (rate) of antibiotic-resistant strains of bacteria established through the use of chlorhexidine identifying dosage form, exposure and specific population and / or setting. Antibiotic-resistant strain of bacteria through the use of chlorhexidine to be recorded. 3. Increases (...) to chlorhexidine in a specific population and / or setting. To address the question ‘Does exposure (different dosages, duration of use, and stratification of exposure) to any form of chlorhexidine increases the incidence and/or prevalence of antibiotic- resistant strains of bacteria in any person within different healthcare settings? ’ the outcomes included: ? ‘Resistance against antibiotics’ defined by using the clinical breakpoints for resistance as specified by the European Committee on Antimicrobial

2018 National Health and Medical Research Council

12. Antibiotic Prophylaxis for Dental Patients at Risk for Infection

of bacterial endocarditis: Recommendations by the American Heart Association. JAMA 1997;227(22):1794-801. 11. Centers for Disease Control and Prevention. Antibiotic/ Antimicrobial resistance. About antimicrobial resistance: A brief overview. Available at: “https://www.cdc.gov/drug resistance/about.html”. Accessed March 26, 2019. Archived by WebCite ® at: “http://www.webcitation.org/ 779R5H5EJ”) 12. Glenny AM, Oliver R, Roberts GJ, Hooper L, Worthington HV. Antibiotics for the prophylaxis of bacterial (...) Antibiotic Prophylaxis for Dental Patients at Risk for Infection 416 THE REFERENCE MANUAL OF PEDIATRIC DENTISTRY BEST PRACTICES: ANTIBIOTIC PROPHYLAXIS Purpose The American Academy of Pediatric Dentistry ( AAPD) recog- nizes that numerous medical conditions predispose patients to bacteremia-induced infections. Because it is not possible to predict when a susceptible patient will develop an infection, prophylactic antibiotics are recommended when these patients undergo procedures

2019 American Academy of Pediatric Dentistry

13. Use of Antibiotic Therapy for Pediatric Dental Patients

/MEDLINE database using the terms: antibiotic therapy, antibacterial agents, antimicrobial agents, dental trauma, oral wound management, orofacial infections, periodontal disease, viral disease, and oral contraception; fields: all; limits: within the last 10 years, humans, English, clinical trials, birth through age 18. Three hundred forty-three articles matched these criteria. Papers for review were chosen from this search and from hand searching. When data did not appear sufficient or were (...) derivatives remain the empirical choice for odontogenic infections; however, consideration of additional adjunctive antimicrobial therapy (i.e., metronidazole) can be given where there is anaerobic bacterial involvement. 13,16 Cephalosporins could be considered as an alternative choice for odontogenic infections. 16 Dental trauma Systemic antibiotics have been recommended as adjunctive therapy for avulsed permanent incisors with an open or closed apex. 17,18 Tetracycline (doxycycline twice daily for seven

2019 American Academy of Pediatric Dentistry

14. 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

15. Adult and Pediatric Antibiotic Prophylaxis during Vascular and IR Procedures: A Society of Interventional Radiology Practice Parameter Update Endorsed by the Cardiovascular and Interventional Radological Society of Europe and the Canadian Association for

procedures, including the increasing prevalence of pediatric IR procedures, and the increasing repertoire of antibacterial agents. As was the case for the original guidelines (1), the availability of randomized controlled data regarding antibiotic prophylaxis is lacking in the IR literature. Much data are derived from retrospective reviews From the Department of Diagnostic Radiology (M.A.C.), Oakland University William Beaumont School of Medicine, Royal Oak, Michigan; Department of Radiology (A.S.T (...) to oropharyngeal ?ora, which can potentially seed the skin entry site. This procedure carries a peristomal infection rate of approximately 30% (156). Prophylactic antibiotic therapy is therefore recommended for all patients undergoing this procedure with antimicrobial agents targeting skin and oropharyngeal bacteria, eg, cefazolin followed by oral/enteric cephalexin (156). (New data reviewed, recommendations updated.) Liver Tumor Ablation In 2015, Bhatia et al (157) described a very low incidence of hepatic ab

2019 Society of Interventional Radiology

16. Diarrhoea - antibiotic associated: Metronidazole

Diarrhoea - antibiotic associated: Metronidazole Metronidazole | Prescribing information | Diarrhoea - antibiotic associated | CKS | NICE Search CKS… Menu Metronidazole Diarrhoea - antibiotic associated: Metronidazole Last revised in March 2019 Metronidazole What are the cautions and contraindications with metronidazole? Do not prescribe metronidazole in people with: Known metronidazole or nitroimidazole hypersensitivity. Prescribe metronidazole with caution in people with: Cockayne syndrome

2019 NICE Clinical Knowledge Summaries

17. Acne vulgaris: Topical antibiotics

Acne vulgaris: Topical antibiotics Topical antibiotics | Prescribing information | Acne vulgaris | CKS | NICE Search CKS… Menu Topical antibiotics Acne vulgaris: Topical antibiotics Last revised in December 2019 Topical antibiotics Topical antibiotics Prescribing issues Topical antibiotics licenced in the UK for treatment of acne vulgaris include clindamycin and erythromycin. Application is usually once or twice a day and varies between agents — for information on specific products see (...) the (BNF) and the . Topical monotherapy with antibiotics is not recommended because of the risk of antibiotic resistance. Topical antibiotics should be prescribed in combination with benzoyl peroxide. Cautions and contraindications Hypersensitivity to the active ingredient or any of the excipients. History of inflammatory bowel disease or a history of antibiotic-associated colitis. If diarrhoea occurs, the product should be discontinued immediately. Caution is advised when prescribing to people

2019 NICE Clinical Knowledge Summaries

18. Acne vulgaris: Oral antibiotics

Acne vulgaris: Oral antibiotics Oral antibiotics | Prescribing information | Acne vulgaris | CKS | NICE Search CKS… Menu Oral antibiotics Acne vulgaris: Oral antibiotics Last revised in December 2019 Oral antibiotics Oral antibiotics Prescribing issues If acne fails to respond adequately to topical preparations alone an oral antibiotic such as lymecycline or doxycycline (for a maximum of 3 months) can be added. Minocycline is not recommended for use in acne as it is associated (...) with an increased risk of adverse effects such as drug-induced lupus, skin pigmentation and hepatitis. Macrolide antibiotics (such as erythromycin) should generally be avoided due to high levels of P. acnes resistance but can be used if tetracyclines are contraindicated (for example in pregnancy). A topical retinoid (if not contraindicated) or benzoyl peroxide should always be co-prescribed with oral antibiotics to reduce the risk of antibiotic resistance developing. Do not use topical and oral antibiotics

2019 NICE Clinical Knowledge Summaries

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