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antibiotic resistance

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141. Subsequent carbapenem-resistant Enterobacteriaceae (CRE)-associated infections among hospitalized patients with CRE colonization: Impact of antibiotic use and other factors. (Abstract)

Subsequent carbapenem-resistant Enterobacteriaceae (CRE)-associated infections among hospitalized patients with CRE colonization: Impact of antibiotic use and other factors. We demonstrated a 20% rate of subsequent carbapenem-resistant Enterobacteriaceae (CRE)-associated infections among hospitalized CRE carriers. Independent factors associated with the infections were number of colonization sites, central-line insertion, and receiving vancomycin before colonization. These findings underscore (...) the importance of antibiotic stewardship and device-related infection control measures to prevent CRE infections.

2020 Infection control and hospital epidemiology

142. Antibiotic resistance is associated with morbidity and mortality after decortication for empyema. (Abstract)

Antibiotic resistance is associated with morbidity and mortality after decortication for empyema. Previous studies of decortication for empyema have demonstrated that patient characteristics are associated with mortality, but the relationship of infectious pathogen to outcome has not been described. Our objective was to analyze the association of microbiology and antibiotic resistance with post-operative mortality following decortication for empyema. We hypothesized that bacterial pathogens (...) , antibiotic resistance and patient characteristics would all contribute to perioperative morbidity and mortality.Patients undergoing pulmonary decortication for empyema from 1/1/2010-10/1/2017 were reviewed retrospectively. Cases were matched to microbiology cultures. The outcomes of interest was a composite of death, tracheostomy, initial ventilator support > 48 hours or unexpected ICU readmission. Antibiotic resistance was categorized as present or absent, and the number of antibiotics with resistance

2020 Annals of Thoracic Surgery

143. Antibiotic resistance in acne: changes, consequences and concerns. (Abstract)

Antibiotic resistance in acne: changes, consequences and concerns. Antibiotic resistance in acne was first observed in the 1970s and has been a major concern in dermatology since the 1980s. The resistance rates and types of antimicrobials have subsequently shown great variations in regions and countries. Illustrative of this is the resistance to topical erythromycin and clindamycin which continues to be a problem worldwide, while resistance to systemic treatment with tetracyclines has remained (...) low during the past decade. The resistance for the newer macrolides like azithromycin and clarithromycin has been increasing. The results of antibiotic resistance may include treatment failure of acne, disturbance of skin microbiota, induction of opportunistic pathogens locally and systemically, and dissemination of resistant strains to both healthcare personnel and the general population. The ensuing complications, such as aggravated opportunistic infections caused by Propionibacterium acnes

2020 Journal of the European Academy of Dermatology and Venereology

144. Quantifying the economic cost of antibiotic resistance and the impact of related interventions: rapid methodological review, conceptual framework and recommendations for future studies. Full Text available with Trip Pro

Quantifying the economic cost of antibiotic resistance and the impact of related interventions: rapid methodological review, conceptual framework and recommendations for future studies. Antibiotic resistance (ABR) poses a major threat to health and economic wellbeing worldwide. Reducing ABR will require government interventions to incentivise antibiotic development, prudent antibiotic use, infection control and deployment of partial substitutes such as rapid diagnostics and vaccines. The scale (...) in hospitals (95/110), used a healthcare provider or payer perspective (97/110), and used matched cohort approaches to compare costs of patients with antibiotic-resistant infections and antibiotic-susceptible infections (or no infection) (87/110). Better use of methods to correct biases and confounding when making this comparison is needed. Findings also need to be extended beyond their limitations in (1) time (projecting present costs into the future), (2) perspective (from the healthcare sector to entire

2020 BMC Medicine

145. Bacteria drug resistance profile affects knee and hip periprosthetic joint infection outcome with debridement, antibiotics and implant retention. Full Text available with Trip Pro

Bacteria drug resistance profile affects knee and hip periprosthetic joint infection outcome with debridement, antibiotics and implant retention. Evaluate the effect of bacteria drug resistance profile on the success rates of debridement, antibiotics and implant retention.All early acute periprosthetic infections in hip and knee arthroplasties treated with DAIR at our institution over the period from 2011 to 2015 were retrospectively analyzed. The success rate was evaluated according (...) to the type of organism identified in culture: multidrug-sensitive (MSB), methicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant Gram-negative bacteria (MRB) and according to other risk factors for treatment failure. The data were analyzed using univariate and multivariate statistics.Fifty-seven patients were analyzed; there were 37 in the multidrug-sensitive bacteria (MSB) group, 11 in the methicillin-resistant Staphylococcus aureus (MRSA) group and 9 in the other multidrug-resistant

2020 BMC Musculoskeletal Disorders

146. Longitudinal assessment of antibiotic resistance gene profiles in gut microbiomes of infants at risk of eczema. Full Text available with Trip Pro

understanding of the naïve infant gut resistome may build the evidence base for antimicrobial stewardship in both humans and in the food industry. Given the high carriage rate of extended spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae in Asia, we aimed to evaluate community prevalence, dynamics, and longitudinal changes in antibiotic resistance gene (ARG) profiles and prevalence of ESBL-producing E. coli and K. pneumoniae in the intestinal microbiome of infants participating in the Growing Up (...) point in the first year of life. Few ARGs persisted throughout the first year of life. Beta-lactam resistant Escherichia coli and Klebsiella pneumoniae were detected in 4 (5.3%) and 32 (42.7%) of subjects respectively.In this longitudinal cohort study of infants living in a region with high endemic antibacterial resistance, we demonstrate that majority of the infants harboured several antibiotic resistance genes in their gut and showed that the infant gut resistome is diverse and dynamic over

2020 BMC Infectious Diseases

147. Association between the rate of fluoroquinolones-resistant gram-negative bacteria and antibiotic consumption from China based on 145 tertiary hospitals data in 2014. Full Text available with Trip Pro

Association between the rate of fluoroquinolones-resistant gram-negative bacteria and antibiotic consumption from China based on 145 tertiary hospitals data in 2014. The purpose of the study is to discuss the correlation between the resistance rate of gram negative bacteria to fluoroquinolones (FQ) and antibiotic consumption intensity of 145 China tertiary hospitals in 2014.This retrospective study adopted national monitoring data from 2014. Each participating hospital required to report annual (...) consumption of each antibiotic, and the resistance rate of gram negative bacteria to FQ. Then the correlation between antibiotic usage and fluoroquinolones -resistant (FQR) rate was consequently investigated.One hundred forty-five hospitals were included in the study, and the median antibiotic consumption intensity was 46.30 (23.93-115.39) defined daily dosages (DDDs) per 100 patient-days. Cephalosporins ranks first in the antibiotics consumption, followed by fluoroquinolones, penicillins, and carbapenems

2020 BMC Infectious Diseases

148. A process for developing a sustainable and scalable approach to community engagement: community dialogue approach for addressing the drivers of antibiotic resistance in Bangladesh. Full Text available with Trip Pro

A process for developing a sustainable and scalable approach to community engagement: community dialogue approach for addressing the drivers of antibiotic resistance in Bangladesh. Community engagement approaches that have impacted on health outcomes are often time intensive, small-scale and require high levels of financial and human resources. They can be difficult to sustain and scale-up in low resource settings. Given the reach of health services into communities in low income countries (...) , the health system provides a valuable and potentially sustainable entry point that would allow for scale-up of community engagement interventions. This study explores the process of developing an embedded approach to community engagement taking the global challenge of antibiotic resistance as an example.The intervention was developed using a sequential mixed methods study design. This consisted of: exploring the evidence base through an umbrella review, and identifying key international standards

2020 BMC Public Health

149. Helicobacter pylori resistance to antibiotics at the An-Najah National University Hospital: a cross-sectional study. Full Text available with Trip Pro

Helicobacter pylori resistance to antibiotics at the An-Najah National University Hospital: a cross-sectional study. Bacterial resistance to antibiotics is considered the most important determinant of treatment failure. Monitoring the evolution of antimicrobial resistance to common antibiotics is therefore of special importance for clinicians. The frequency of resistance to antibiotics in Helicobacter pylori isolates is increasing. The aim of this study was to determine the pattern of H pylori (...) %). Metronidazole and clarithromycin were the least effective drugs, with resistance rates of 100% and 47%, respectively.H pylori isolates from the Palestinian patients included in this study were highly resistant to the traditional first-line antibiotics clarithromycin and metronidazole. However, fluoroquinolones and amoxicillin are still effective antimicrobial choices. This could be the result of the unjustified wide use of antibiotics in the Palestinian community and the use of clarithromycin-based therapy

2018 Lancet

150. Constraints-based analysis identifies NAD+ recycling through metabolic reprogramming in antibiotic resistant Chromobacterium violaceum. Full Text available with Trip Pro

Constraints-based analysis identifies NAD+ recycling through metabolic reprogramming in antibiotic resistant Chromobacterium violaceum. In the post genomic era, high throughput data augment stoichiometric flux balance models to compute accurate metabolic flux states, growth and energy phenotypes. Investigating altered metabolism in the context of evolved resistant genotypes potentially provide simple strategies to overcome drug resistance and induce susceptibility to existing antibiotics (...) . A genome-scale metabolic model (GSMM) for Chromobacterium violaceum, an opportunistic human pathogen, was reconstructed using legacy data. Experimental constraints were used to represent antibiotic susceptible and resistant populations. Model predictions were validated using growth and respiration data successfully. Differential flux distribution and metabolic reprogramming were identified as a response to antibiotics, chloramphenicol and streptomycin. Streptomycin resistant populations (StrpR

2019 PLoS ONE

151. Putative antibiotic resistance genes present in extant Bacillus licheniformis and Bacillus paralicheniformis strains are probably intrinsic and part of the ancient resistome. Full Text available with Trip Pro

Putative antibiotic resistance genes present in extant Bacillus licheniformis and Bacillus paralicheniformis strains are probably intrinsic and part of the ancient resistome. Whole-genome sequencing and phenotypic testing of 104 strains of Bacillus licheniformis and Bacillus paralicheniformis from a variety of sources and time periods was used to characterize the genetic background and evolution of (putative) antimicrobial resistance mechanisms. Core proteins were identified in draft genomes (...) and a phylogenetic analysis based on single amino acid polymorphisms allowed the species to be separated into two phylogenetically distinct clades with one outlier. Putative antimicrobial resistance genes were identified and mapped. A chromosomal ermD gene was found at the same location in all B. paralichenformis and in 27% of B. licheniformis genomes. Erythromycin resistance correlated very well with the presence of ermD. The putative streptomycin resistance genes, aph and aadK, were found in the chromosome

2019 PLoS ONE

152. Decontamination Strategies and Bloodstream Infections With Antibiotic-Resistant Microorganisms in Ventilated Patients: A Randomized Clinical Trial. Full Text available with Trip Pro

Decontamination Strategies and Bloodstream Infections With Antibiotic-Resistant Microorganisms in Ventilated Patients: A Randomized Clinical Trial. The effects of chlorhexidine (CHX) mouthwash, selective oropharyngeal decontamination (SOD), and selective digestive tract decontamination (SDD) on patient outcomes in ICUs with moderate to high levels of antibiotic resistance are unknown.To determine associations between CHX 2%, SOD, and SDD and the occurrence of ICU-acquired bloodstream infections (...) with multidrug-resistant gram-negative bacteria (MDRGNB) and 28-day mortality in ICUs with moderate to high levels of antibiotic resistance.Randomized trial conducted from December 1, 2013, to May 31, 2017, in 13 European ICUs where at least 5% of bloodstream infections are caused by extended-spectrum β-lactamase-producing Enterobacteriaceae. Patients with anticipated mechanical ventilation of more than 24 hours were eligible. The final date of follow-up was September 20, 2017.Standard care was daily CHX 2

2018 JAMA Controlled trial quality: predicted high

153. Triple Antibiotic Solution Promotes Similar Antibacterial Effects as Calcium Hydroxide/2% Chlorhexidine When Used as an Intracanal Medicament

instrumentation and/or irrigation, are effective in canal disinfection. The intracanal antimicrobial efficacy of triple antibiotic formulation is shown to be superior to calcium hydroxide alone, or at least comparable to calcium hydroxide combined with 2% chlorhexidine when assessing antibacterial efficacy and clinical outcomes. Perspective: Randomized clinical trials are currently the highest available evidence comparing use of triple antibiotic paste against other canal medicaments in primary teeth (...) Triple Antibiotic Solution Promotes Similar Antibacterial Effects as Calcium Hydroxide/2% Chlorhexidine When Used as an Intracanal Medicament UTCAT3361, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Triple Antibiotic Solution Promotes Similar Antibacterial Effects as Calcium Hydroxide/2% Chlorhexidine When Used as an Intracanal Medicament Clinical Question In patients undergoing non-surgical therapy in a tooth

2018 UTHSCSA Dental School CAT Library

154. Do Antibiotics Improve Outcomes in Patients With Acute Asthma Exacerbations? Full Text available with Trip Pro

with inhaled β-agonists and corticosteroids. A minority of asthma exacerbations are due to bacterial infection. Antibiotics stewardship means being judicious about their use to limit adverse events, resistance, and unnecessary cost. Although the guidance is clear on administering antibiotics for asthma only when physical examination signs or ancillary testing is suggestive of bacterial infection, x 2 British Thoracic Society; Scottish Intercollegiate Guidelines Network. British guideline on the management (...) . There was significant clinical heterogeneity between studies and patient populations (despite low statistical heterogeneity), including different treatment settings and different antibiotic regimens (type of drug and route). Furthermore, one of the aims of the meta-analysis was to assess adverse events, but too few were reported, rendering the studies underpowered. Also, there is no mechanism to identify the effect of antibiotics given in these studies on development of drug-resistant organisms. This review

2020 Annals of Emergency Medicine Systematic Review Snapshots

155. What Is the Utility of Prophylactic Antibiotics for Patients After Cardiac Arrest? Full Text available with Trip Pro

on Resuscitation; the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; the Council on Stroke. Resuscitation . 2008 ; 79 : 350–379 | | | | | Consequently, prophylactic antibiotics may seem reasonable in this population. However, it is important to balance this against the need for antimicrobial stewardship. Although this study demonstrated (...) . The duration of antibiotic administration was not available for any of the studies. It is also possible that the infection may have been resistant to the chosen antibiotic and that a different antibiotic may have been more effective. Moreover, studies were conducted over a wide range of time, with several of them conducted before modern advances in resuscitation, including therapeutic hypothermia. There was also significant statistical heterogeneity for all of the outcomes except overall mortality. Studies

2020 Annals of Emergency Medicine Systematic Review Snapshots

156. Cefiderocol (Fetcroja) - antibiotic

involved 152 adults with various serious infections caused by bacteria that were resistant to carbapenems (could not be killed by antibiotics called carbapenems). For lung infections, 50% of patients treated with Fetcroja were cured based on a lack of symptoms, compared with 53% of Fetcroja (cefiderocol) EMA/115665/2020 Page 2/2 those treated with the best alternative treatment. For bloodstream infections, these figures were 44% and 43%, respectively. For complicated urinary tract infections, 53 (...) Cefiderocol (Fetcroja) - antibiotic Official address Domenico Scarlattilaan 6 ? 1083 HS Amsterdam ? The Netherlands An agency of the European Union Address for visits and deliveries Refer to www.ema.europa.eu/how-to-find-us Send us a question Go to www.ema.europa.eu/contact Telephone +31 (0)88 781 6000 © European Medicines Agency, 2020. Reproduction is authorised provided the source is acknowledged. EMA/115665/2020 EMEA/H/C/004829 Fetcroja (cefiderocol) An overview of Fetcroja and why

2020 European Medicines Agency - EPARs

157. Non-inferiority versus superiority trial design for new antibiotics in an era of high antimicrobial resistance: the case for post-marketing, adaptive randomised controlled trials. Full Text available with Trip Pro

Non-inferiority versus superiority trial design for new antibiotics in an era of high antimicrobial resistance: the case for post-marketing, adaptive randomised controlled trials. Antimicrobial resistance is one of the most important threats to global health security. A range of Gram-negative bacteria associated with high morbidity and mortality are now resistant to almost all available antibiotics. In this context of urgency to develop novel drugs, new antibiotics for multidrug-resistant Gram (...) a major challenge in the development, registration, and post-marketing implementation of new antibiotics. Using an example of the development process of ceftazidime-avibactam, we propose a strategy for a new research framework based on adaptive randomised clinical trials. The operational research strategy has the aim of assessing the efficacy of new antibiotics in special groups of patients, such as those infected with multidrug-resistant bacteria, who were not included in earlier phase studies

2019 Lancet infectious diseases

158. Impact of antimicrobial stewardship managed by clinical pharmacists on antibiotic use and drug resistance in a Chinese hospital, 2010-2016: a retrospective observational study. Full Text available with Trip Pro

Impact of antimicrobial stewardship managed by clinical pharmacists on antibiotic use and drug resistance in a Chinese hospital, 2010-2016: a retrospective observational study. 'National Special Stewardship in the Clinical Use of Antibiotics' was put forward in July 2011 in China. We aimed to retrospectively evaluate the impact of antimicrobial stewardship (AMS) managed by clinical pharmacists on antibiotic utilisation, prophylaxis and antimicrobial resistance (AMR).This was a retrospective (...) management, advising on antibacterial prescriptions and training.The proportion of antibiotic prescriptions among outpatients and inpatients, intensity of consumption in defined daily dose (DDD)/100 bed-days, antibiotic prophylaxis in type I incision operations and resistance rates of Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa were retrospectively analysed.The proportion of antibiotic prescriptions decreased in outpatients (from 19.38% to 13.21%) and in inpatients (from 64.34

2019 BMJ open

159. Targets for the reduction of antibiotic use in humans in the Transatlantic Taskforce on Antimicrobial Resistance (TATFAR) partner countries. Full Text available with Trip Pro

Targets for the reduction of antibiotic use in humans in the Transatlantic Taskforce on Antimicrobial Resistance (TATFAR) partner countries. Unnecessary and inappropriate use of antibiotics in human healthcare is a major driver for the development and spread of antimicrobial resistance; many countries are implementing measures to limit the overuse and misuse of antibiotics e.g. through the establishment of antimicrobial use reduction targets. We performed a review of antimicrobial use reduction (...) indicated that they have established targets to reduce antimicrobial use in humans. Twenty-one countries replied that no target had been established. However, 17 of these 21 countries indicated that work to establish such targets is currently underway, often in the context of developing a national action plan against antimicrobial resistance. The reported targets varied greatly between countries and can be a useful resource for countries willing to engage in the reduction of antibiotic use in humans.

2019 Euro Surveillance

160. Using a period incidence survey to compare antibiotic use in children between a university hospital and a district hospital in a country with low antimicrobial resistance: a prospective observational study. Full Text available with Trip Pro

Using a period incidence survey to compare antibiotic use in children between a university hospital and a district hospital in a country with low antimicrobial resistance: a prospective observational study. To describe and compare antibiotic use in relation to indications, doses, adherence rate to guidelines and rates of broad-spectrum antibiotics (BSA) in two different paediatric departments with different academic cultures, and identify areas with room for improvement.Prospective (...) observational survey of antibiotic use.Paediatric departments in a university hospital (UH) and a district hospital (DH) in Norway, 2017. The registration period was 1 year at the DH and 4 months at the UH.201 children at the DH (mean age 3.8: SD 5.1) and 137 children at the UH (mean age 2.0: SD 5.9) were treated with systemic antibiotics by a paediatrician in the study period and included in the study.Main outcome variables were prescriptions of antibiotics, treatments with antibiotics, rates of BSA

2019 BMJ open

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