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1821. Management of chemotherapy extravasation

Melphalan Cytarabine Daunorubicin Anthracyclines (other): Etoposide phosphate Epirubicin Liposomal doxorubicin Gemcitabine Idarubicin Liposomal Daunorubicin Fludarabine Others (antibiotics) Mitoxantrone Interferons Dactinomycin Topoisomerase II inhibitors Interleukin-2 Mitomycin C Etoposide Methotrexate Mitoxantrone a Teniposide Monoclonal antibodies Non-DNA-binding compounds Antimetabolites Pemetrexed Vinka alkaloids Fluorouracil Raltitrexed Vincristine Platin salts Temsirolimus Vinblastine Carboplatin (...) on non-biopsy con?rmed data and in many cases, simultaneous treatment with antibiotics was initiated. It should be also considered that many of the recommendations date back to a drug’s original registration, which can be several decades ago when requirements for approval were less strict. general measures Regardless of the chemotherapy drug, early initiation of treatment is considered mandatory. In this context, patient education is crucial for a prompt identi?cation of the extravasation.The

2012 European Society for Medical Oncology

1822. Lipomodelling Guidelines for Breast Surgery

(Making the best use of clinical radiology services, 6th edition, 2007, Royal College of Radiologists.). However, breast cancer patients should have an initial follow-up mammogram before commencing lipomodelling. e) Operative issues The procedure may be carried out either under local or general anaesthesia. Antibiotic prophylaxis and thromboprophylaxis may be appropriate depending on individual assessment and local protocols. Fat grafting may appear to be a simple procedure. However, the success

2011 Association of Breast Surgery

1823. Diarrhoea and vomiting caused by gastroenteritis in under 5s: diagnosis and management

reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2 of 26Contents Contents Introduction 4 Key priorities for implementation 5 Diagnosis 5 Assessing dehydration and shock 5 Fluid management 5 Nutritional management 6 Information and advice for parents and carers 7 1 Guidance 8 1.1 Diagnosis 8 1.2 Assessing dehydration and shock 10 1.3 Fluid management 13 1.4 Nutritional management 16 1.5 Antibiotic therapy 16 1.6 Other therapies 17 1.7 (...) in children is multifaceted. There is evidence of variation in clinical practice, which may have a major impact on the use of healthcare resources. This guideline applies to children younger than 5 years who present to a healthcare professional for advice in any setting. It covers diagnosis, assessment of dehydration, fluid management, nutritional management and the role of antibiotics and other therapies. It provides recommendations on the advice to be given to parents and carers, and also considers when

2009 National Institute for Health and Clinical Excellence - Clinical Guidelines

1825. Canadian consensus guidelines for the management of testicular germ cell cancer

. 114 Prophylactic antibiotic treatment has been shown to reduce febrile neutropenia during chemother- apy with no change in mortality and may be considered in some patients. 115,116 In patients with life-threatening “poor” prognosis disease, orchiectomy should not delay the initiation of curative ther- apy and can be performed at the end of therapy. 117-120 It is recommended that these patients be referred to special- ized centres for optimal multidisciplinary management and supportive care

2010 CPG Infobase

1827. Best Practice in the Management of Epidural Analgesia in the Hospital Setting

be associated with poor analgesia and need for large volumes of infusion in adults. 5.3 The catheter should be secured in order to minimise movement in or out of the epidural space. The dressing should allow easy visibility of the insertion site and catheter. 5.4 Anaesthetists inserting epidural catheters should be aware of, and adhere to, local infection guidelines (including use of prophylactic antibiotics in special circumstances). 5.5 Local guidelines should be in place with respect to the insertion

2011 Association of Anaesthetists of GB and Ireland

1828. Management of Proximal Femoral Fractures

. Thromboembolism stockings or intermittent compression devices should be employed intra-operatively, in addition to ensuring the Grif?ths et al. | Guidelines: proximal hip fractures Anaesthesia 2011 Anaesthesia ª 2011 The Association of Anaesthetists of Great Britain and Ireland 19patient remains warm and well-hydrated. Expedited surgery and mobilisation, and regional anaesthesia, may reduce the risk of DVT further. Antibiotics Antibiotics should be administered within one hour of skin incision. Hospital (...) antibiotic protocols should be followed. Pressure care Older patients are particularly susceptible to pressure damage. Patients should be positioned sympathetically during surgery, to avoid the development of pressure sores and/or neuropraxia. Excessive ?exion and internal rotation of the non-operative hip should be resisted during dynamic hip screw insertion. The skin of older patients is thin and liable to be damaged by minimal trauma. Care should be taken when removing dressings or diathermy plates

2011 Association of Anaesthetists of GB and Ireland

1829. Clinical practice guidelines for surveillance colonoscopy - in adenoma follow-up; following curative resection of colorectal cancer; and for cancer surveillance in inflammatory bowel disease (December 2011)

; – the need for antibiotic prophylaxis; and – diabetes mellitus. o Patients cancelled on the day due to unforeseen co- morbidities. Informed consent should be obtained from all patients or their parent/legal guardian, using a structured approach. Preferably, it should be obtained before the period of bowel preparation. The patient needs to understand what is involved in the procedure and the possible risks, both in general and in the patient’s specific case (Table 1.2). What will your patients expect

2011 Clinical Practice Guidelines Portal

1830. Breastfeeding. Evidence based guidelines for the use of medicines

guides to medicines and breastfeeding. Therapeutic Guidelines have been independently prepared by expert writing groups experienced in therapeutics, pharmacology and use of antibiotics and psychotropic drugs without input from pharmaceutical companies. 14,15 The Pregnancy and Breastfeeding: Medicines Guide is prepared by the pharmacy department at the Royal Women’s hospital (Victoria) as a guide for health professionals to select appropriate treatment for women during pregnancy and when breastfeeding (...) . Common postpartum infections and recommended agents Infection Antibiotic guideline 14 Breastfeeding recommendation 16,17 Mastitis Systemic symptoms, early treatment with antibiotics Severe cellulitis, antibiotics should be given intravenously • Di/flucloxacillin • Cephalexin • Cephalothin • Cephazolin Compatible Compatible Compatible Compatible Patients with immediate penicillin hypersensitivity • Clindamycin • Lincomycin • V ancomycin Compatible Compatible Compatible Methicillin resistant

2011 Clinical Practice Guidelines Portal

1831. Evidence-based guidelines for use of probiotics in preterm neonates

in different studies, role of breast milk, pitfalls of TSA, lack of availability of safe and effective products, development of antibiotic resistance, cross-contamination and long-term adverse effects (AEs) as reasons for opposing routine use of probiotics in pre- term neonates [19-23]. We have previously addressed these concerns [24], and pointed out that probiotic research has completed a full circle, from basic science [25] and cohort studies [26], to conclusive meta-analysis [14], routine use [15 (...) AND antibio- tic susceptibility.mp. or antibiotic sensitivity; probiotic. mp. or probiotic agent AND Sepsis; probiotic.mp. or probiotic agent AND bacterial translocation; probiotic. mp. or probiotic agent AND legislation.mp. or licence/ or law/; probiotic.mp. or probiotic agent AND informed consent; probiotics.mp. or probiotic agent AND tem- perature/or drug storage/or drug packaging/or cold chain.mp. or drug stability/or freezing/; probiotic.mp. or probiotic agent quality assurance.mp. or quality control

2011 Clinical Practice Guidelines Portal

1832. Australian Association for Exercise and Sports Science position statement on exercise and asthma Full Text available with Trip Pro

and/or stop therapy with antiperistaltic agents and opiates Promote the use of narrow spectrum antimicrobial agents Stop therapy with other antibiotics if possible; if not, a prolonged course of treatment for CDI may be required Perform serial clinical assessment Perform serial assessments of white cell count, and lactate, creatinine and electrolyte levels Treatment of initial episode Metronidazole, 400 mg orally, three times daily for 10 days If unable to tolerate oral treatment: metronidazole, 500 mg (...) Topics Abstract Clostridium difficile is the most common cause of health care-associated and antibiotic-associated diarrhoea. C lostridium difficile is a frequent cause of both nosocomial and antibiotic-associated diarrhoea, and is usually health care-associated. It is infrequently found in the gastrointestinal tract of healthy adults, but may colonise up to two-thirds of young children before they are weaned. In healthy people, C. difficile does not cause problems; resistance to infection is thought

2011 Clinical Practice Guidelines Portal

1833. Lactational mastitis and breast abscess. Diagnosis and management in general practice

practice. Discussion Lactational mastitis is usually bacterial in aetiology and can generally be effectively managed with oral antibiotics. Infections that do not improve rapidly require further investigation for breast abscess and nonlactational causes of inflammation, including the rare cause of inflammatory breast cancer. In addition to antibiotics, management of lactational breast infections include symptomatic treatment, assessment of the infant’s attachment to the breast, and reassurance (...) or anatomical conditions such as cleft palate or tongue-tie which may interfere with attachment. 6,9 Observation of breastfeeding can determine if there are difficulties with attachment to the breast. A lactation consultant may be helpful. Investigation Mastitis is a clinical diagnosis and investigations are not indicated in the initial assessment. 1 breast infection that does not improve with a course of appropriate antibiotics should be investigated with breast ultrasound. 5 This may distinguish

2011 Clinical Practice Guidelines Portal

1834. 2011 update to NHFA and CSANZ guidelines for the prevention, detection and management of chronic heart failure in Australia

Institute ? exible diuretic regimen Acute infection Antibiotic Rx as appropriate Institute ? exible diuretic regimen New arrhythmia e.g. atrial ? brillation Refer Acute ischaemia/infarction Refer Other e.g. anaemia, pulmonary embolism Refer Institute ? exible diuretic regimen (20 mg frusemide for each kilogram of weight gain) No improvement within 24 hours (no weight loss or weight gain) Improved (next day weight loss) Refer Resume previous dose Review maintenance medicine Is ACEI, beta-blocker dose

2011 Clinical Practice Guidelines Portal

1835. Guidelines for the prevention, detection and management of chronic heart failure (updated October 2011)

Institute ? exible diuretic regimen Acute infection Antibiotic Rx as appropriate Institute ? exible diuretic regimen New arrhythmia e.g. atrial ? brillation Refer Acute ischaemia/infarction Refer Other e.g. anaemia, pulmonary embolism Refer Institute ? exible diuretic regimen (20 mg frusemide for each kilogram of weight gain) No improvement within 24 hours (no weight loss or weight gain) Improved (next day weight loss) Refer Resume previous dose Review maintenance medicine Is ACEI, beta-blocker dose

2011 Clinical Practice Guidelines Portal

1836. Prevention, identification and management of foot complications in diabetes

management and early institution of antibacterial therapy • MRI for diagnosing osteomyelitis in patients with diabetic foot ulcers (but at higher cost) • Novel therapies such as bio-engineered live skin equivalents and hyperbaric oxygen therapy (HBOT) None of these evaluations considered the Australian context and some had methodological issues such that some of the results may be overstated and need to be interpreted with caution. The authors of the studies conclude that more quality economic studies (...) , should foot assessments be carried out in people with or without foot ulcer? EO 3-5 5 When should a patient be referred to a high risk foot clinic? (What are the risk factors for a poor foot related outcome for people in a primary care setting?) EO 11 Intervention 6 Which interventions improve foot related clinical outcomes – a) For people without foot ulceration? b) For people with foot ulcer? EBR 6-14, EO 6, EO 8-10 7 Under what circumstances are antibiotics effective in the treatment of foot

2011 Clinical Practice Guidelines Portal

1837. Australian consensus guidelines for the management of neutropenic fever in adult cancer patients

in a clinic or home setting. Greater guidance is provided so that clinicians can con?dently implement ambulatory strategies for neutropenic fever, where appropriate. A recommended approach to ambulatory care is provided in the adjunct paper by Worth etal. 15 Antibacterial prophylaxis While the 2002 IDSA guidelines discouraged use of antibiotic prophylaxis with ?uoroquinolones (FQ) for neutropenicpatientsowingtoconcernsofemerginganti- biotic resistance, 3 recent evidence suggests this approach may reduce (...) -aminoglycoside combination therapy in cancer patients with neutropaenia. Cochrane Database Syst Rev. 2003; CD003038. 20 Tam C, O’Reilly M, Andresen D, Lingaratnam S, Kelly A, Burbury K etal. Use of empiric antimicrobial therapy in neutropenic fever. Intern Med J. 2010; 41b: 90–101. 21 Kern WV. Risk assessment and risk-based therapeutic strategies in febrile neutropenia. Curr Opin Infect Dis. 2001; 14: 415–22. 22 Gafter-Gvili A, Fraser A, Paul M, Leibovici L. Meta-analysis: antibiotic prophylaxis reduces

2011 Clinical Practice Guidelines Portal

1838. UK National Guideline for the Management of Pelvic Inflammatory Disease

, and empirical antibiotic treatment, should be considered and usually offered in any young (under 25) sexually active woman who has recent onset, bilateral lower abdominal pain associated with local tenderness on bimanual vaginal examination, in whom pregnancy has been excluded. Complications • Women with HIV may have more severe symptoms associated with PID but respond well to standard antibiotic therapy 6 . No change in treatment recommendations compared to HIV uninfected patients is required 7-9 . (Grade (...) of this, and the lack of definitive diagnostic criteria, a low threshold for empiric treatment of PID is recommended. Broad spectrum antibiotic therapy is required PID guideline V4 page 6 to cover N. gonorrhoeae, C. trachomatis and a variety of aerobic and anaerobic bacteria commonly isolated from the upper genital tract in women with PID 1, 2 . Some of the best evidence for the effectiveness of antibiotic treatment in preventing the long term complications of PID comes from the PEACH study where women were treated

2011 British Association for Sexual Health and HIV

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