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221. Antibiotic treatment for nontuberculous mycobacteria lung infection in people with cystic fibrosis. Full Text available with Trip Pro

with cystic fibrosis leading to more a rapid decline in lung function and even death in certain circumstances. Although there are guidelines for the antimicrobial treatment of nontuberculous mycobacteria lung disease, these recommendations are not specific for people with cystic fibrosis and it is not clear which antibiotic regimen may be the most effective in the treatment of these individuals. This is an update of a previous review.The objective of our review was to compare antibiotic treatment (...) Antibiotic treatment for nontuberculous mycobacteria lung infection in people with cystic fibrosis. Nontuberculous mycobacteria are mycobacteria, other than those in the Mycobacterium tuberculosis complex, and are commonly found in the environment. Nontuberculous mycobacteria species (most commonly Mycobacterium avium complex and Mycobacterium abscessus) are isolated from the respiratory tract of approximately 5% to 40% of individuals with cystic fibrosis; they can cause lung disease in people

2016 Cochrane

222. Antibiotic treatment for Stenotrophomonas maltophilia in people with cystic fibrosis. Full Text available with Trip Pro

Antibiotic treatment for Stenotrophomonas maltophilia in people with cystic fibrosis. Stenotrophomonas maltophilia is one of the most common emerging multi-drug resistant organisms found in the lungs of people with cystic fibrosis and its prevalence is increasing. Chronic infection with Stenotrophomonas maltophilia has recently been shown to be an independent predictor of pulmonary exacerbation requiring hospitalization and antibiotics. However, the role of antibiotic treatment (...) of Stenotrophomonas maltophilia infection in people with cystic fibrosis is still unclear. This is an update of a previously published review.The objective of our review is to assess the effectiveness of antibiotic treatment for Stenotrophomonas maltophilia in people with cystic fibrosis. The primary objective is to assess this in relation to lung function and pulmonary exacerbations in the setting of acute pulmonary exacerbations. The secondary objective is to assess this in relation to the eradication

2016 Cochrane

223. Duration of intravenous antibiotic therapy in people with cystic fibrosis. Full Text available with Trip Pro

Duration of intravenous antibiotic therapy in people with cystic fibrosis. Respiratory disease is the major cause of mortality and morbidity in cystic fibrosis. Life expectancy of people with cystic fibrosis has increased dramatically in the last 40 years. One of the major reasons for this increase is the mounting use of antibiotics to treat chest exacerbations caused by bacterial infections. The optimal duration of intravenous antibiotic therapy is not clearly defined. Individuals usually (...) receive intravenous antibiotics for 14 days, but treatment may range from 10 to 21 days. A shorter duration of antibiotic treatment risks inadequate clearance of infection which could lead to further lung damage. Prolonged courses of intravenous antibiotics are expensive and inconvenient and the incidence of allergic reactions to antibiotics also increases with prolonged courses. The use of aminoglycosides requires frequent monitoring to avoid some of their side effects. However, some organisms which

2016 Cochrane

224. Different antibiotic treatments for group A streptococcal pharyngitis. Full Text available with Trip Pro

Different antibiotic treatments for group A streptococcal pharyngitis. Antibiotics provide only modest benefit in treating sore throat, although effectiveness increases in participants with positive throat swabs for group A beta-haemolytic streptococci (GABHS). It is unclear which antibiotic is the best choice if antibiotics are indicated.To assess the evidence on the comparative efficacy of different antibiotics in: (a) alleviating symptoms (pain, fever); (b) shortening the duration (...) of the illness; (c) preventing relapse; and (d) preventing complications (suppurative complications, acute rheumatic fever, post-streptococcal glomerulonephritis). To assess the evidence on the comparative incidence of adverse effects and the risk-benefit of antibiotic treatment for streptococcal pharyngitis.We searched CENTRAL (2016, Issue 3), MEDLINE Ovid (1946 to March week 3, 2016), Embase Elsevier (1974 to March 2016), and Web of Science Thomson Reuters (2010 to March 2016). We also searched clinical

2016 Cochrane

225. Written information for patients (or parents of child patients) to reduce the use of antibiotics for acute upper respiratory tract infections in primary care. Full Text available with Trip Pro

Written information for patients (or parents of child patients) to reduce the use of antibiotics for acute upper respiratory tract infections in primary care. Acute upper respiratory tract infections (URTIs) are frequently managed in primary care settings. Although many are viral, and there is an increasing problem with antibiotic resistance, antibiotics continue to be prescribed for URTIs. Written patient information may be a simple way to reduce antibiotic use for acute URTIs.To assess (...) if written information for patients (or parents of child patients) reduces the use of antibiotics for acute URTIs in primary care.We searched CENTRAL, MEDLINE, Embase, CINAHL, LILACS, Web of Science, clinical trials.gov, and the World Health Organization (WHO) trials registry up to July 2016 without language or publication restrictions.We included randomised controlled trials (RCTs) involving patients (or parents of child patients) with acute URTIs, that compared written patient information delivered

2016 Cochrane

226. Interventions to improve antimicrobial prescribing of doctors in training (IMPACT): a realist review Full Text available with Trip Pro

Interventions to improve antimicrobial prescribing of doctors in training (IMPACT): a realist review Interventions to improve antimicrobial prescribing of doctors in training (IMPACT): a realist review Journals Library An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could not be found. Please choose a page from the navigation or try a website search above to find the information you need (...) . >> >> >> >> Issue {{metadata .Issue }} Toolkit 1)"> 0)"> 1)"> {{metadata.Title}} {{metadata.Headline}} This review identified a number of implications on how interventions can be developed to enable optimal tailoring, design and implementation of antimicrobial prescribing interventions targeted at doctors-in-training. {{author}} {{($index , , , , & . Chrysanthi Papoutsi 1, * , Karen Mattick 2 , Mark Pearson 3 , Nicola Brennan 4 , Simon Briscoe 3 , Geoff Wong 1 1 Nuffield Department of Primary Care Health

2018 NIHR HTA programme

227. Quantitative study?other: Structured antibiotic ?time-out? audits as recommended by the CDC reduce antibiotic use and costs Full Text available with Trip Pro

-out’ audits as recommended by the CDC reduce antibiotic use and costs Peter G Davey Statistics from Altmetric.com Commentary on: Lee TC , Frenette C , Jayaraman D et al . Antibiotic self-stewardship: trainee-led structured antibiotic time-outs to improve antimicrobial use . Implications for practice and research Self-monitoring is a highly effective behaviour change technique, which should be more widely used in improving prescribing in hospitals and more generally in changing professional (...) Quantitative study?other: Structured antibiotic ?time-out? audits as recommended by the CDC reduce antibiotic use and costs Structured antibiotic ‘time-out’ audits as recommended by the CDC reduce antibiotic use and costs | Evidence-Based Nursing 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

2016 Evidence-Based Nursing

228. Effects of primary care antimicrobial stewardship outreach on antibiotic use by general practice staff: pragmatic randomized controlled trial of the TARGET antibiotics workshop. Full Text available with Trip Pro

Effects of primary care antimicrobial stewardship outreach on antibiotic use by general practice staff: pragmatic randomized controlled trial of the TARGET antibiotics workshop. To determine whether local trainer-led TARGET antibiotic interactive workshops improve antibiotic dispensing in general practice.Using a McNulty-Zelen-design randomized controlled trial within three regions of England, 152 general practices were stratified by clinical commissioning group, antibiotic dispensing rate (...) %, P = 0.06). The Complier Average Causal Effect (CACE) analysis, which estimates impact in those that comply with assigned intervention, indicated 6.1% (95% CI 0.2%-11.7%, P = 0.04) lower total antibiotic dispensing in intervention practices and 11% (95% CI 1.6%-19.5%, P = 0.02) lower trimethoprim dispensing.This study within usual service provision found that TARGET antibiotic workshops can help improve antibiotic use, and therefore should be considered as part of any national antimicrobial

2018 Journal of Antimicrobial Chemotherapy Controlled trial quality: predicted high

229. Antibacterial properties of the pituitary adenylate cyclase-activating polypeptide: A new human antimicrobial peptide. Full Text available with Trip Pro

Antibacterial properties of the pituitary adenylate cyclase-activating polypeptide: A new human antimicrobial peptide. The Pituitary Adenylate Cyclase-Activating Polypeptide (PACAP), a polycationic, amphiphilic and helical neuropeptide, is well known for its neuroprotective actions and cell penetrating properties. In the present study, we evaluated the potent antibacterial property of PACAP38 and related analogs against various bacterial strains. Interestingly, PACAP38 and related analogs can (...) inhibit the growth of various bacteria including Escherichia coli (JM109), Bacillus subtilis (PY79), and the pathogenic Burkholderia cenocepacia (J2315). Investigation of the mechanism of action suggested that a PACAP metabolite, identified as PACAP(9-38), might indeed be responsible for the observed PACAP38 antibacterial action. Surprisingly, PACAP(9-38), which does not induce haemolysis, exhibits an increased specificity toward Burkholderia cenocepacia J2315 compared to other tested bacteria

2018 PLoS ONE

230. Sinusitis (acute): antimicrobial prescribing

Background 5 Recommendations 6 1.1 Managing acute sinusitis 6 1.2 Choice of antibiotic 8 1.3 Self-care 10 Symptoms and signs 12 Common symptoms and signs 12 Factors that might make a bacterial cause more likely 12 Summary of the evidence 13 Self-care 13 Nasal corticosteroids 14 No antibiotic 15 Back-up antibiotics 17 Choice of antibiotic 18 Antibiotic course length 21 Other considerations 23 Medicines adherence 23 Resource implications 23 Sinusitis (acute): antimicrobial prescribing (NG79) © NICE 2019 (...) . All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 24Ov Overview erview This guideline sets out an antimicrobial prescribing strategy for acute sinusitis. It aims to limit antibiotic use and reduce antimicrobial resistance. Acute sinusitis is usually caused by a virus, lasts for about 2 to 3 weeks, and most people get better without antibiotics. Withholding antibiotics rarely leads to complications. See a 2-page visual

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

231. Antimicrobial stewardship: changing risk-related behaviours in the general population

Behavioural strategies and programmes 42 3 High-risk groups 42 4 Workplace 43 5 Older people in day and residential care 43 Antimicrobial stewardship: changing risk-related behaviours in the general population (NG63) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 4 of 44Ov Overview erview This guideline covers making people aware of how to correctly use antimicrobial medicines (including antibiotics) and the dangers (...) section on NHS Choices] or there is a high risk of travellers' diarrhoea). The following recommendations are for local authority public health teams. 1.2.4 Consider linking to awareness-raising initiatives for the public on reducing inappropriate antimicrobial demand and use and antimicrobial resistance (for example, European Antibiotic Awareness Day and Public Health England's Antibiotic Guardian). 1.2.5 Use opportunities that may arise through other local authority activities to distribute

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

232. C-Reactive Protein Testing to Guide Antibiotic Prescribing for COPD Exacerbations. Full Text available with Trip Pro

C-Reactive Protein Testing to Guide Antibiotic Prescribing for COPD Exacerbations. Point-of-care testing of C-reactive protein (CRP) may be a way to reduce unnecessary use of antibiotics without harming patients who have acute exacerbations of chronic obstructive pulmonary disease (COPD).We performed a multicenter, open-label, randomized, controlled trial involving patients with a diagnosis of COPD in their primary care clinical record who consulted a clinician at 1 of 86 general medical (...) practices in England and Wales for an acute exacerbation of COPD. The patients were assigned to receive usual care guided by CRP point-of-care testing (CRP-guided group) or usual care alone (usual-care group). The primary outcomes were patient-reported use of antibiotics for acute exacerbations of COPD within 4 weeks after randomization (to show superiority) and COPD-related health status at 2 weeks after randomization, as measured by the Clinical COPD Questionnaire, a 10-item scale with scores ranging

2019 NEJM Controlled trial quality: predicted high

233. Antibiotic or silver versus standard ventriculoperitoneal shunts (BASICS): a multicentre, single-blinded, randomised trial and economic evaluation. Full Text available with Trip Pro

Antibiotic or silver versus standard ventriculoperitoneal shunts (BASICS): a multicentre, single-blinded, randomised trial and economic evaluation. Insertion of a ventriculoperitoneal shunt for hydrocephalus is one of the commonest neurosurgical procedures worldwide. Infection of the implanted shunt affects up to 15% of these patients, resulting in prolonged hospital treatment, multiple surgeries, and reduced cognition and quality of life. Our aim was to determine the clinical and cost (...) -effectiveness of antibiotic (rifampicin and clindamycin) or silver shunts compared with standard shunts at reducing infection.In this parallel, multicentre, single-blind, randomised controlled trial, we included patients with hydrocephalus of any aetiology undergoing insertion of their first ventriculoperitoneal shunt irrespective of age at 21 regional adult and paediatric neurosurgery centres in the UK and Ireland. Patients were randomly assigned (1:1:1 in random permuted blocks of three or six) to receive

2019 Lancet

234. Mechanical and oral antibiotic bowel preparation versus no bowel preparation for elective colectomy (MOBILE): a multicentre, randomised, parallel, single-blinded trial. (Abstract)

Mechanical and oral antibiotic bowel preparation versus no bowel preparation for elective colectomy (MOBILE): a multicentre, randomised, parallel, single-blinded trial. Decreased surgical site infections (SSIs) and morbidity have been reported with mechanical and oral antibiotic bowel preparation (MOABP) compared with no bowel preparation (NBP) in colonic surgery. Several societies have recommended routine use of MOABP in patients undergoing colon resection on the basis of these data. Our aim

2019 Lancet Controlled trial quality: predicted high

235. Use of Antibiotics Without a Prescription in the U.S. Population: A Scoping Review. (Abstract)

Use of Antibiotics Without a Prescription in the U.S. Population: A Scoping Review. Use of antibiotics without a prescription may increase unnecessary and inappropriate drug use or doses as well as global risk for antimicrobial resistance.To perform a scoping review of research on the prevalence of nonprescription antibiotic use in the United States and to examine the factors that influence it.Searches of PubMed, EMBASE, CINAHL, Scopus, and relevant Web sites without language restrictions from (...) January 2000 to March 2019.Studies reporting nonprescription use of antibiotics, storage of antibiotics, intention to use antibiotics without a prescription, and factors influencing nonprescription use.Two reviewers independently screened citations and full texts and performed data abstraction.Of 17 422 screened articles, 31 met inclusion criteria. Depending on population characteristics, prevalence of nonprescription antibiotic use varied from 1% to 66%, storage of antibiotics for future use varied

2019 Annals of Internal Medicine

236. Excess Antibiotic Treatment Duration and Adverse Events in Patients Hospitalized With Pneumonia: A Multihospital Cohort Study. (Abstract)

Excess Antibiotic Treatment Duration and Adverse Events in Patients Hospitalized With Pneumonia: A Multihospital Cohort Study. Randomized trials demonstrate no benefit from antibiotic treatment exceeding the shortest effective duration.To examine predictors and outcomes associated with excess duration of antibiotic treatment.Retrospective cohort study.43 hospitals in the Michigan Hospital Medicine Safety Consortium.6481 general care medical patients with pneumonia.The primary outcome (...) was the rate of excess antibiotic treatment duration (excess days per 30-day period). Excess days were calculated by subtracting each patient's shortest effective (expected) treatment duration (based on time to clinical stability, pathogen, and pneumonia classification [community-acquired vs. health care-associated]) from the actual duration. Negative binomial generalized estimating equations (GEEs) were used to calculate rate ratios to assess predictors of 30-day rates of excess duration. Patient outcomes

2019 Annals of Internal Medicine

237. Long-term follow-up of the AVOD randomized trial of antibiotic avoidance in uncomplicated diverticulitis (Abstract)

Long-term follow-up of the AVOD randomized trial of antibiotic avoidance in uncomplicated diverticulitis The aim of this study was to assess the long-term results in patients with uncomplicated diverticulitis who had participated in the Antibiotics in Acute Uncomplicated Diverticulitis (AVOD) RCT, which randomized patients with CT-verified left-sided acute uncomplicated diverticulitis to management without or with antibiotics.The medical records of patients who had participated in the AVOD (...) trial were reviewed for long-term results such as recurrences, complications and surgery. Quality-of-life questionnaires (EQ-5D™) were sent to patients, who were also contacted by telephone. Descriptive statistics were used for the analysis of clinical outcomes.A total of 556 of the 623 patients (89·2 per cent) were followed up for a median of 11 years. There were no differences between the no-antibiotic and antibiotic group in recurrences (both 31·3 per cent; P = 0·986), complications (4·4 versus 5

2019 EvidenceUpdates

238. Guideline-Based Clinical Assessment Versus Procalcitonin-Guided Antibiotic Use in Pneumonia: A Pragmatic Randomized Trial (Abstract)

Guideline-Based Clinical Assessment Versus Procalcitonin-Guided Antibiotic Use in Pneumonia: A Pragmatic Randomized Trial Efforts to reduce unnecessary and unnecessarily long antibiotic treatment for community-acquired pneumonia have been attempted through use of procalcitonin and through guidelines based on serial clinical assessment. Our aim is to compare guideline-based clinical assessment- and procalcitonin algorithm-guided antibiotic use among patients with community-acquired pneumonia.We (...) performed a pragmatic, randomized, multicenter trial from November 2012 to April 2015 at 12 French hospitals. We included emergency department (ED) patients older than 18 years with community-acquired pneumonia. Patients were randomly assigned to either the procalcitonin-guided or clinical assessment group. In accordance with past studies, we hypothesized that serial clinical assessment would be superior to procalcitonin-guided care. The primary outcome was antibiotic duration, and secondary outcomes

2019 EvidenceUpdates

239. CRP-guided antibiotic treatment in acute exacerbations of COPD in hospital admissions (Abstract)

CRP-guided antibiotic treatment in acute exacerbations of COPD in hospital admissions The role of antibiotics in acute exacerbations of chronic obstructive pulmonary disease (COPD) is controversial and a biomarker identifying patients who benefit from antibiotics is mandatory. We performed a randomised, controlled trial in patients with acute exacerbations of COPD, comparing C-reactive protein (CRP)-guided antibiotic treatment to patient reported symptoms in accordance with the Global (...) Initiative for Chronic Obstructive Lung Disease (GOLD) strategy, in order to show a reduction in antibiotic prescription.Patients hospitalised with acute exacerbations of COPD were randomised to receive antibiotics based either on the GOLD strategy or according to the CRP strategy (CRP ≥50 mg·L-1).In total, 101 patients were randomised to the CRP group and 119 to the GOLD group. Fewer patients in the CRP group were treated with antibiotics compared to the GOLD group (31.7% versus 46.2%, p=0.028; adjusted

2019 EvidenceUpdates

240. Two weeks versus four weeks of antibiotic therapy after surgical drainage for native joint bacterial arthritis: a prospective, randomised, non-inferiority trial Full Text available with Trip Pro

Two weeks versus four weeks of antibiotic therapy after surgical drainage for native joint bacterial arthritis: a prospective, randomised, non-inferiority trial The optimal duration of postsurgical antibiotic therapy for adult native joint bacterial arthritis remains unknown.We conducted a prospective, unblinded, randomised, non-inferiority study comparing either 2 or 4 weeks of antibiotic therapy after surgical drainage of native joint bacterial arthritis in adults. Excluded were implant (...) -related infections, episodes without surgical lavage and episodes with a follow-up of less than 2 months.We enrolled 154 cases: 77 in the 4-week arm and 77 in the 2-week arm. Median length of intravenous antibiotic treatment was 1 and 2 days, respectively. The median number of surgical lavages was 1 in both arms. Recurrence of infection was noted in three patients (2%): 1 in the 2-week arm (99% cure rate) and 2 in the 4-week arm (97% cure rate). There was no difference in the number of adverse events

2019 EvidenceUpdates

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