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136621. A single intravenous injection of KRN5500 (antibiotic spicamycin) produces long-term decreases in multiple sensory hypersensitivities in neuropathic pain. (Abstract)

A single intravenous injection of KRN5500 (antibiotic spicamycin) produces long-term decreases in multiple sensory hypersensitivities in neuropathic pain. Neuropathic pain is a significant clinical problem. Currently, there are no drugs that produce complete amelioration of this type of pain. We have previously shown that KRN5500, a derivative of the antibiotic spicamycin, produces a prolonged (7-day), and significant reduction in neuropathic pain, but not nociceptive pain. Herein, we provide

2003 Anesthesia and Analgesia

136622. Antibiotic prescription practices, consumption and bacterial resistance in a cross section of Swedish intensive care units. (Abstract)

in infectious diseases responsible for antibiotic treatment the consumption pattern was different only for use of glycopeptides (58% lower usage than in other ICUs: 26 vs. 11 DDD1000,P=0.02). Only 21% of the ICUs had a written guideline on the use of antibiotics, 57% received information on antibiotic usage at least every 3 months and 22% received aggregated resistance data annually. Clinically significant antimicrobial resistance was found among Enterbacter spp. to cephalosporins and among Enterococcus spp (...) Antibiotic prescription practices, consumption and bacterial resistance in a cross section of Swedish intensive care units. The purpose of this work was to study usage of antibiotics, its possible determinants, and patterns of bacterial resistance in Swedish intensive care units (ICUs).Prospectively collected data on species and antibiotic resistance of clinical isolates and antibiotic consumption specific to each ICU in 1999 were analyzed together with answers to a questionnaire. Antibiotic

2002 Acta Anaesthesiologica Scandinavica

136623. Hypersensitivity reactions to beta-lactam antibiotics. (Abstract)

Hypersensitivity reactions to beta-lactam antibiotics. Clinicians commonly encounter patients with a history of allergy to penicillin and other beta-lactam antibiotics, since about 10% of the population reports such an allergy. At the same time, it is known that about 90% of these patients are not truly allergic and could safely receive beta-lactam antibiotics. Instead, these patients are treated unnecessarily with alternate broad-spectrum antibiotics, which increases costs and contributes (...) when they are well and not in immediate need of antibiotic therapy. Patients who are found to be penicillin skin test-negative may be safely treated with all beta-lactam antibiotics. Penicillin skin test-positive patients should only receive a penicillin-class antibiotic via rapid desensitization, and only in cases when an alternative agent cannot be substituted. Penicillin skin test-positive patients may be safely treated with monobactams. The extent of allergic cross-reactivity between penicillin

2003 Clinical Reviews in Allergy & Immunology

136624. Hypersensitivity reactions to non-beta-lactam antibiotics. (Abstract)

Hypersensitivity reactions to non-beta-lactam antibiotics. As alternatives to beta lactam antibiotics continue to be developed, an increasing number of patients are experiencing hypersensitivity reactions to these agents. Unfortunately, unlike penicillin, there are no validated skin testing reagents to aid in confirming the presence of specific IgE antibodies to these drugs. This review summarizes what is known about hypersensitivity reactions to non-beta lactam antibiotics, and includes

2003 Clinical Reviews in Allergy & Immunology

136625. Oral antibiotic adverse reactions after penicillin skin testing: multi-year follow-up. (Abstract)

Oral antibiotic adverse reactions after penicillin skin testing: multi-year follow-up. Long-term follow-up data on adverse drug reactions after oral antibiotic use in penicillin allergy history positive individuals with penicillin skin test done in advance of need are rare.Oral antibiotic associated adverse drug reactions in 83 penicillin skin test positive individuals were compared to a sex, age, and length of follow-up matched sample of 166 penicillin skin test negative individuals, all (...) of whom had at least one post penicillin skin test oral antibiotic. The mean post penicillin skin test follow-up interval was 34.5 +/- 16.6 months. There were 1655 total oral antibiotic exposures.In penicillin skin test positive individuals, the adverse drug reaction rate was not significantly different with cephalosporin or non-beta-lactam use (P = 0.12). In penicillin skin test negative individuals the adverse drug reaction rate was significantly lower with cephalosporin vs. non-beta-lactam use (P

2002 Allergy

136626. Continuity of antibiotic therapy in patients admitted from the emergency department. (Abstract)

Continuity of antibiotic therapy in patients admitted from the emergency department. We describe discontinuities in antibiotic therapy in patients with community-acquired pneumonia admitted from the emergency department (ED) to an inpatient unit.We performed a retrospective cohort study of patients with community-acquired pneumonia admitted from the ED to the internal medicine service at an academic tertiary care hospital between July 1997 and June 1999. We characterized the frequency (...) of antibiotic delays after arrival on the inpatient unit in relation to antibiotic dosing intervals. We performed paired analysis on the patients treated both with an antibiotic dosed every 6 hours and an antibiotic dosed every 24 hours.Three hundred seventy-five patients were identified. The mean age was 61 years. Sixty-two percent were female. Five hundred fifty-one antibiotic doses were started in the ED and continued on the inpatient unit, with 177 ordered every 6 hours, and 351 ordered every 24 hours

2003 Annals of Emergency Medicine

136627. Use of antibiotics is not associated with decreased risk of myocardial infarction among patients with diabetes. (Abstract)

Use of antibiotics is not associated with decreased risk of myocardial infarction among patients with diabetes. To study the relationship between exposure to antibiotic treatment and risk of subsequent myocardial infarction (MI) in patients with diabetes.A case-control design was used to assess the effect of previous antibiotic exposure in diabetes patients with acute, nonfatal or fatal MI (case subjects) and individually matched control subjects (four control subjects to one case subject (...) , matched on sex, age, and index date). Subjects were sampled from the Northern California Kaiser Permanente Diabetes Registry, a well-characterized, ethnically diverse diabetic population from Kaiser Permanente Medical Care Program, Northern California Region. MI events were ascertained during a 2-year observation period (1998-1999). Separate conditional logistic regression models were specified to assess antibiotic exposure history (cephalosporins only, penicillins only, macrolides only, quinolones

2003 Diabetes Care

136628. Antibiotics in cutaneous medicine: an update. (Abstract)

Antibiotics in cutaneous medicine: an update. Antibiotics play a vital role in contemporary cutaneous medicine and surgery. They are prescribed more commonly than perhaps any other group of medications with the exception of the corticosteroids. This review discusses the major oral antibacterial agents used in dermatology today, including the beta-lactams, macrolides, tetracyclines, quinolones, sulfonamides, clindamycin, and rifampin.

2003 Seminars in Cutaneous Medicine and Surgery

136629. Supernatants of Pseudomonas aeruginosa induce the Pseudomonas-specific antibiotic elafin in human keratinocytes. (Abstract)

Supernatants of Pseudomonas aeruginosa induce the Pseudomonas-specific antibiotic elafin in human keratinocytes. Elafin is a skin-derived serine-protease inhibitor. It is thought to be important to prevent human leukocyte elastase-mediated tissue damage and might play an important role in maintaining the integrity of the human epidermis. Recent studies have provided evidence for an antimicrobial activity of elafin against P. aeruginosa. As gram-negative infections typically occur in barrier (...) response factor induced by secreted products of P. aeruginosa. Besides its elastase inhibitory potency elafin is an antimicrobial agent against P. aeruginosa.

2003 Experimental Dermatology

136630. Prospective study of depressive symptoms and quality of life in acne vulgaris patients treated with isotretinoin compared to antibiotic and topical therapy. (Abstract)

Prospective study of depressive symptoms and quality of life in acne vulgaris patients treated with isotretinoin compared to antibiotic and topical therapy. There have been recent concerns about the possible association between isotretinoin therapy and depressive symptoms. We conducted a prospective study to evaluate depressive symptoms and quality of life in acne patients having either isotretinoin or antibiotics/topical treatments. There were 215 patients (mean age 20 years) included

2002 Australasian Journal of Dermatology

136631. Topical antibacterial agents for wound care: a primer. (Abstract)

Topical antibacterial agents for wound care: a primer. Although often overlooked, topical antibiotic agents play an important role in dermatology. Their many uses include prophylaxis against cutaneous infections, treatment of minor wounds and infections, and elimination of nasal carriage of Staphylococcus aureus. For these indications, they are advantageous over their systemic counterparts because they deliver a higher concentration of medication directly to the desired area and are less (...) frequently implicated in causing bacterial resistance. The ideal topical antibiotic has a broad spectrum of activity, has persistent antibacterial effects, and has minimal toxicity or incidence of allergy.

2003 Dermatologic Surgery

136632. A case of recurrent acute generalized exanthematous pustulosis due to beta-lactam antibiotics: a case report. (Abstract)

A case of recurrent acute generalized exanthematous pustulosis due to beta-lactam antibiotics: a case report. A case of acute generalized exanthematous pustulosis (AGEP) is presented. The case is notable for the recurrent episodes of AGEP, caused by three beta-lactam antibiotics (piperacillin, ceftazidime, and meropenem) in septicemic patient. The case represents the first report of the reaction developing in response to these three antibiotics. The report is also notable for the spontaneous

2003 Journal of Dermatological Treatment

136633. Effect of antibiotics on the oropharyngeal flora in patients with acne. Full Text available with Trip Pro

Effect of antibiotics on the oropharyngeal flora in patients with acne. To estimate the prevalence and resistance patterns of Streptococcus pyogenes and Staphylococcus aureus in the oropharynx of individuals with acne who were using or not using antibiotic therapy.A cross-sectional study.The Dermatology Department of the Hospital of the University of Pennsylvania, Philadelphia.Patients with acne.Presence or absence of S pyogenes and S aureus in the oropharynx as determined by culture (...) and their resistance patterns to tetracycline antibiotics as determined by agar disk diffusion.Of 105 patients who participated, 42 were using oral or topical antibiotics and 63 patients were not using antibiotics. Six (10%) of those 63 not using any antibiotics had positive S pyogenes cultures compared with 13 (33%) of those successfully evaluated using antibiotics (n = 39) (prevalence risk ratio, 3.5; 95% confidence interval, 1.4-8.6; P=.003). A total of 85% of S pyogenes cultures (11/13) from those using

2003 Archives of Dermatology

136634. Antibiotic-resistant acne: lessons from Europe. (Abstract)

Antibiotic-resistant acne: lessons from Europe. Propionibacterium acnes and P. granulosum are widely regarded as the aetiological agents of inflammatory acne. Their proliferation and metabolism are controlled using lengthy courses of oral and/or topical antibiotics. Despite numerous reports of skin colonization by antibiotic-resistant propionibacteria among acne patients, accurate prevalence data are available only for the U.K.To determine the prevalence of skin colonization by antibiotic (...) -resistant propionibacteria among acne patients and their contacts from six European centres.Skin swabs were collected from 664 acne patients attending centres in the U.K., Spain, Italy, Greece, Sweden and Hungary. Phenotypes of antibiotic-resistant propionibacteria were determined by measuring the minimum inhibitory concentrations (MIC) of a panel of tetracycline and macrolide, lincosamide and streptogramin B (MLS) antibiotics. Resistance determinants were characterized by polymerase chain reaction (PCR

2003 British Journal of Dermatology

136635. Antibiotics in primary prevention of myocardial infarction among elderly patients with hypertension. (Abstract)

Antibiotics in primary prevention of myocardial infarction among elderly patients with hypertension. Given the premise that certain bacteria (such as Chlamydia pneumoniae) may play a role in the etiology of atherosclerosis, subjects treated with antibiotics that have antibacterial activity against C pneumoniae may be at lower risk for the development of an acute myocardial infarction (MI) than untreated subjects.A case-control design, nested within a cohort of 29,937 elderly subjects in whom (...) antihypertensive therapy was initiated (1982-1995) was used, in which each subject who was hospitalized with a primary discharge diagnosis of MI between 1987 and 1995 (n = 1047) was matched on calendar time to 5 randomly selected control subjects for exposure contrasts. Conditional logistic regression analyses were conducted to adjust for predisposing factors for MI.Although no clear consistent effect of antibiotics use was found in relation to MI, a trend was observed for a decreased risk of acute MI

2003 American Heart Journal

136636. Binding of outer surface protein A and human lymphocyte function-associated antigen 1 peptides to HLA-DR molecules associated with antibiotic treatment-resistant Lyme arthritis. (Abstract)

Binding of outer surface protein A and human lymphocyte function-associated antigen 1 peptides to HLA-DR molecules associated with antibiotic treatment-resistant Lyme arthritis. To assess the binding of outer surface protein A (OspA) and human lymphocyte function-associated antigen 1 (hLFA-1) peptides to 5 major histocompatibility complex (MHC) molecules.Peptide binding to the MHC molecules was determined by in vitro binding assays, and binding was correlated with the frequencies of the 5 MHC (...) alleles in patients with treatment-resistant arthritis, but the binding of hLFA-1alpha(L330-342) showed only an association with the DRB*04 alleles.These correlations support the hypothesis that OspA(163-175) is the critical epitope in triggering antibiotic treatment-resistant Lyme arthritis. However, the inability of the DRB*0101 molecule to bind hLFA-1alpha(L330-342) suggests that this peptide may not be a relevant autoantigen, at least in DRB1*0101-positive patients.

2003 Arthritis and Rheumatism

136637. A retrospective review of three antibiotic prophylaxis regimens for pediatric cardiac surgical patients. (Abstract)

A retrospective review of three antibiotic prophylaxis regimens for pediatric cardiac surgical patients. Optimal antimicrobial prophylaxis for the pediatric cardiac surgical patient is unknown. We have reviewed our experience with more than 4,000 pediatric cardiac surgical patients at the University of Michigan to evaluate antibiotic prophylaxis regimens.Three antibiotic prophylaxis protocols were serially used during a 6-year period: Protocol 1 (n = 786): cefazolin was administered before (...) % for protocol 2 and 9.3% for protocol 3). Bloodstream infections per 1,000 patient days for protocols 1, 2, and 3 were 2.18, 6.51, and 5.02, respectively (p < 0.05 protocol 1 versus protocols 2 and 3).These data suggest that pediatric cardiac surgical patients may benefit from prophylactic antibiotics as long as thoracostomy tubes are in place.

2002 Annals of Thoracic Surgery

136638. Inflammatory and microbiologic markers in induced sputum after intravenous antibiotics in cystic fibrosis. (Abstract)

Inflammatory and microbiologic markers in induced sputum after intravenous antibiotics in cystic fibrosis. Induced sputum has been used to study airway inflammation. We sought to determine whether markers of infection and inflammation in induced sputum were a useful and safe outcome measure in cystic fibrosis. We hypothesized that bacterial density and inflammatory content of induced sputum would decrease after antibiotic therapy. Induced sputum was assayed for bacterial density, cell count (...) , and differential and inflammatory markers before and after treatment with intravenous antibiotics. Fifty-five of the 72 subjects enrolled (mean age +/- SD 18.2 +/- 7.9 years) completed the study. FEV1 increased by an average 0.3 +/- 0.3 L (10.4 +/- 8.7% predicted FEV1), p<0.0001; density of Pseudomonas aeruginosa and Staphylococcus aureus decreased by 2.4 +/- 3.1 log10 cfu/g (p<0.0005) and 4.0 +/- 2.3 log10 cfu/ml (p<0.0001), respectively; neutrophil count decreased by 0.4 +/- 0.6 log10 cells/ml (p<0.0001

2003 American Journal of Respiratory and Critical Care Medicine

136639. In vivo and in vitro effects of macrolide antibiotics on mucus secretion in airway epithelial cells. Full Text available with Trip Pro

In vivo and in vitro effects of macrolide antibiotics on mucus secretion in airway epithelial cells. To examine the in vivo effects of macrolide antibiotics on mucus hypersecretion, we induced hypertrophic and metaplastic changes of goblet cells in rat nasal epithelium by intranasal instillation of ovalbumin (OVA) in OVA-sensitized rats and by intranasal LPS instillation. Oral administration of clarithromycin (CAM) (5-10 mg/kg) significantly inhibited OVA- and LPS-induced mucus production (...) and neutrophil infiltration, whereas josamycin and ampicillin showed no effect. In vitro effects of macrolide antibiotics on airway epithelial cells were examined using NCI-H292 cells and human nasal epithelial cells cultured in air-liquid interface. Mucus secretion was evaluated by ELISA using anti-mucin monoclonal antibodies (anti-MUC5AC and HCS18). CAM and erythromycin significantly inhibited spontaneous and tumor necrosis factor-alpha (20 ng/ml)-induced mucus secretion from NCI-H292 cells at 10-6 to 10-7

2003 American Journal of Respiratory and Critical Care Medicine

136640. Incidence and risk factors of oral antibiotic-associated diarrhea in an outpatient pediatric population. (Abstract)

Incidence and risk factors of oral antibiotic-associated diarrhea in an outpatient pediatric population. Little information is available on the epidemiologic characteristics of antibiotic-associated diarrhea (AAD) in children. The authors' aim was to evaluate the incidence of AAD in an outpatient pediatric population and to identify risk factors.Children aged 1 month to 15.4 years treated with oral antibiotics for a proven or suspected infection were enrolled from an ambulatory pediatric (...) practice during an 11-month period. Parents recorded the daily frequency and characteristics of stools using a diary during the antibiotic treatment and for 1 week after it was stopped. An episode of diarrhea was defined by at least 3 soft or liquid stools/d for at least 2 consecutive days. Risk factors for AAD-age, type of antibiotic treatment, type of combined treatment, and site of infection-were analyzed.Of 650 children included, 11% had an episode of AAD, lasting a mean of 4.0 +/- 3.0 days

2003 Journal of Pediatric Gastroenterology and Nutrition

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