Latest & greatest articles for antibiotics

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This page lists the very latest high quality evidence on antibiotics and also the most popular articles. Popularity measured by the number of times the articles have been clicked on by fellow users in the last twelve months.

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Antibiotics

Antibiotics also referred to as antibacterial are a type of medicine that prevents the growth of bacteria. As such they are used to treat infections caused by bacteria. They kill or prevents bacteria from spreading.

Antibiotics are vital in modern day medicine; they are among the most frequently prescribed drug. There are over a 100 types of antibiotics, the main types and most commonly prescribed are penicillin, cephalosporin, macrolides, fluoroquinolone and tetracycline. They tend to be classified by mechanism of action. So, those that target the bacterial cell wall (penicillins and cephalosporins) or the cell membrane (polymyxins), or interfere with essential bacterial enzymes (rifamycins, lipiarmycins, quinolones, and sulfonamides) have bactericidal activities. Antibiotics such as macrolides, lincosamides and tetracyclines inhibit protein synthesis.

Antibiotics can all be defined by their specificity. “Narrow-spectrum” antibiotics target specific types of bacteria, for instance gram-negative (-ve) or gram-positive (+ve), whereas broad-spectrum antibiotics affect a wide range of bacteria.

Antibiotics are increasingly suffering from antibiotic resistance caused by bacterial mutations meaning the bacteria evolves to not be sensitive to the specific antibiotics being used.

Clinical trials are important to the development and understanding of antibiotics and their side effects. Although they are deemed safe, over use of the drug can kill good bacteria and lead to antibiotic resistance. This halts the ability of bacteria and microorganisms to resist the effects of the antibiotic. Clinical trials and research allow scientists and medical professionals to study the effects and develop new antibiotics.

Trip has extensive coverage of the evidence base on antibiotics allowing users to easily find trusted answers. Coverage include guidelines, systematic reviews, controlled trials and evidence-based synopses.

Top results for antibiotics

1. Tools for GPs can help reduce unnecessary antibiotic prescribing

Tools for GPs can help reduce unnecessary antibiotic prescribing Tools for GPs can help reduce unnecessary antibiotic prescribing Dissemination Centre Discover Portal NIHR DC Discover Tools for GPs can help reduce unnecessary antibiotic prescribing Published on 30 October 2018 doi: Interventions to reduce inappropriate antibiotic prescribing for upper respiratory tract infections are most effective when they provide a negotiation tool to support patient interaction. These interventions are more (...) likely to be rejected if they are perceived as interfering with individual clinical judgment or damaging patient relationships. Upper respiratory tract infections often resolve themselves within a few days, without the need for antibiotics, yet antibiotics are often prescribed. This systematic review of qualitative studies explored what primary care professionals who prescribe thought about interventions designed to reduce antibiotic prescribing for acute respiratory infections. These findings

NIHR Dissemination Centre2018

2. Advances in optimizing the prescription of antibiotics in outpatient settings.

Advances in optimizing the prescription of antibiotics in outpatient settings. The inappropriate use of antibiotics can increase the likelihood of antibiotic resistance and adverse events. In the United States, nearly a third of antibiotic prescriptions in outpatient settings are unnecessary, and the selection of antibiotics and duration of treatment are also often inappropriate. Evidence shows that antibiotic prescribing is influenced by psychosocial factors, including lack of accountability (...) , perceived patient expectations, clinician workload, and habit. A varied and growing body of evidence, including meta-analyses and randomized controlled trials, has evaluated interventions to optimize the use of antibiotics. Interventions informed by behavioral science-such as communication skills training, audit and feedback with peer comparison, public commitment posters, and accountable justification-have been associated with improved antibiotic prescribing. In addition, delayed prescribing, active

BMJ2018

6. The Hidden Cost of Commercial Antibiotic-Loaded Bone Cement: A Systematic Review of Clinical Results and Cost Implications Following Total Knee Arthroplasty

The Hidden Cost of Commercial Antibiotic-Loaded Bone Cement: A Systematic Review of Clinical Results and Cost Implications Following Total Knee Arthroplasty 30217400 2018 09 15 1532-8406 2018 Aug 13 The Journal of arthroplasty J Arthroplasty The Hidden Cost of Commercial Antibiotic-Loaded Bone Cement: A Systematic Review of Clinical Results and Cost Implications Following Total Knee Arthroplasty. S0883-5403(18)30681-8 10.1016/j.arth.2018.08.009 The purpose of this systematic review (...) is to compare deep prosthetic joint infections (PJIs) between total knee arthroplasty (TKA) patients treated with either antibiotic-loaded bone cement (ALBC) or plain bone cement, and to explore the potential cost implications of commonly used bone cement regimens. We hypothesized that ALBC would not substantially reduce PJIs and would thereby present an unnecessary cost to the healthcare system. Using the PRISMA guidelines, we reviewed articles through May 2017 involving primary TKA patients with both ALBC

EvidenceUpdates2018

7. Inhaled antibiotics for pulmonary exacerbations in cystic fibrosis.

Inhaled antibiotics for pulmonary exacerbations in cystic fibrosis. BACKGROUND: Cystic fibrosis is a genetic disorder in which abnormal mucus in the lungs is associated with susceptibility to persistent infection. Pulmonary exacerbations are when symptoms of infection become more severe. Antibiotics are an essential part of treatment for exacerbations and inhaled antibiotics may be used alone or in conjunction with oral antibiotics for milder exacerbations or with intravenous antibiotics (...) for more severe infections. Inhaled antibiotics do not cause the same adverse effects as intravenous antibiotics and may prove an alternative in people with poor access to their veins. This is an update of a previously published review. OBJECTIVES: To determine if treatment of pulmonary exacerbations with inhaled antibiotics in people with cystic fibrosis improves their quality of life, reduces time off school or work and improves their long-term survival. SEARCH METHODS: We searched the Cochrane

Cochrane2018

8. Prophylactic antibiotic therapy for chronic obstructive pulmonary disease (COPD).

Prophylactic antibiotic therapy for chronic obstructive pulmonary disease (COPD). BACKGROUND: There has been renewal of interest in the use of prophylactic antibiotics to reduce the frequency of exacerbations and improve quality of life in chronic obstructive pulmonary disease (COPD). OBJECTIVES: To determine whether or not regular (continuous, intermittent or pulsed) treatment of COPD patients with prophylactic antibiotics reduces exacerbations or affects quality of life. SEARCH METHODS: We (...) searched the Cochrane Airways Group Trials Register and bibliographies of relevant studies. The latest literature search was performed on 27 July 2018. SELECTION CRITERIA: Randomised controlled trials (RCTs) that compared prophylactic antibiotics with placebo in patients with COPD. DATA COLLECTION AND ANALYSIS: We used the standard Cochrane methods. Two independent review authors selected studies for inclusion, extracted data, and assessed risk of bias. We resolved discrepancies by involving a third

Cochrane2018

9. Study shows no benefit of an antibiotic for acute asthma

Study shows no benefit of an antibiotic for acute asthma Signal - Study shows no benefit of an antibiotic for acute asthma Dissemination Centre Discover Portal NIHR DC Discover Study shows no benefit of an antibiotic for acute asthma Published on 21 December 2016 The antibiotic azithromycin did not reduce symptoms or change other outcomes in adults seeking emergency care for an acute asthma attack. However people not already taking antibiotics were hard to find and the trial failed to enrol (...) enough people to answer the research question. In this UK-based trial, people with asthma who received azithromycin on top of standard treatment with corticosteroids had no better symptoms ten days later than people who received corticosteroids alone. Almost half of almost 4,600 potential participants had already been given antibiotics. This study shows that many people are being prescribed antibiotics to treat an asthma attack despite British guidance stating that antibiotics should not be routinely

NIHR Dissemination Centre2018

10. Blood test could shorten antibiotic treatment in newborns with suspected sepsis

Blood test could shorten antibiotic treatment in newborns with suspected sepsis Signal - Blood test could shorten antibiotic treatment in newborns with suspected sepsis Dissemination Centre Discover Portal NIHR DC Discover Blood test could shorten antibiotic treatment in newborns with suspected sepsis Published on 28 November 2017 Measuring procalcitonin levels in newborns with suspected sepsis in the first days of life reduced antibiotic duration by 10 hours compared with standard care (...) . There was no increase in the risk of re-infection or death. Systemic infection can be rapidly life-threatening in newborn babies, so those with risk factors are often treated pre-emptively with intravenous antibiotics. If sepsis is not confirmed by blood culture the decision whether to discontinue antibiotics needs to be made, but results of the blood culture takes time. Procalcitonin is released into the blood in response to inflammation, and low levels may give an earlier indication that there is no serious

NIHR Dissemination Centre2018

11. Computerised decision support can improve antibiotic prescribing in hospitals

Computerised decision support can improve antibiotic prescribing in hospitals Signal - Computerised decision support can improve antibiotic prescribing in hospitals Dissemination Centre Discover Portal NIHR DC Discover Computerised decision support can improve antibiotic prescribing in hospitals Published on 28 November 2017 Using a computerised decision support tool (software used by hospital prescribers) improved the adequacy of antibiotic coverage and adherence to guidelines, and may have (...) reduced the risk of people dying. Only four studies reported on resistance to antibiotics, so no conclusions can be drawn about the impact of this tool on resistance. Antibiotic stewardship programmes aim to get prescribers to think before they decide to prescribe antibiotics, then consider the type and dose of antibiotic. Computerised decision support aims to support this practice by embedding these principles into everyday practice. This review suggests that computerised decision support tools may

NIHR Dissemination Centre2018

12. A strategy of 'delayed antibiotic prescribing' for respiratory infections may reduce antibiotic use

A strategy of 'delayed antibiotic prescribing' for respiratory infections may reduce antibiotic use Signal - A strategy of 'delayed antibiotic prescribing' for respiratory infections may reduce antibiotic use Dissemination Centre Discover Portal NIHR DC Discover A strategy of 'delayed antibiotic prescribing' for respiratory infections may reduce antibiotic use Published on 19 December 2017 Delaying antibiotic prescribing made little difference to most symptoms of respiratory infection. It (...) reduced antibiotic use and did not affect patient satisfaction compared with immediate prescribing of antibiotics. Increasing antibiotic resistance is a global health concern. Many people don’t realise that viruses cause most respiratory infections and that antibiotics won’t help. The strategy allows some time for symptoms to improve naturally. This review of the latest evidence on delayed prescribing for self-limiting respiratory infections is in line with current guidance. On the whole delaying

NIHR Dissemination Centre2018

13. Blood test reduces mortality and shortens antibiotic use among adults with chest infection

Blood test reduces mortality and shortens antibiotic use among adults with chest infection Signal - Blood test reduces mortality and shortens antibiotic use among adults with chest infection Dissemination Centre Discover Portal NIHR DC Discover Blood test reduces mortality and shortens antibiotic use among adults with chest infection Published on 16 January 2018 It may be feasible to use procalcitonin blood levels to guide antibiotic treatment for adults in hospital with a suspected chest (...) infection. By measuring procalcitonin, an indicator of bacterial infection, clinicians could review their diagnosis earlier. This reduced antibiotic exposure by 2.5 days with fewer adverse effects and also less mortality. About 14 extra people in every 1,000 who had their management guided by the blood test would be expected to survive the first month, compared with those receiving standard care without this test. Antibiotics are commonly prescribed pre-emptively for a suspected respiratory infection

NIHR Dissemination Centre2018

14. Intravenous antibiotics, administered over 3 hours, are linked to lower death rates in sepsis

Intravenous antibiotics, administered over 3 hours, are linked to lower death rates in sepsis Signal - Intravenous antibiotics, administered over 3 hours, are linked to lower death rates in sepsis Dissemination Centre Discover Portal NIHR DC Discover Intravenous antibiotics, administered over 3 hours, are linked to lower death rates in sepsis Published on 31 January 2018 The risk of death in adults with sepsis was 30% lower when each dose of antibiotic was given intravenously over three hours (...) compared to a bolus or less than 60 minutes. This systematic review included adults on intensive care units with a range of ages, severity of sepsis and other symptoms. A variety of antibiotics of the anti-pseudomonal beta-lactam class were used in the trials. These included carbapenems, penicillins and cephalosporins. In the UK, current guidance for intravenous use of these drugs is to give them over a period of up to 30 minutes. This review provides high-quality evidence that suggests that all

NIHR Dissemination Centre2018

15. Carefully managed antibiotic use could halve antibiotic-resistant infections

Carefully managed antibiotic use could halve antibiotic-resistant infections Signal - Carefully managed antibiotic use could halve antibiotic-resistant infections Dissemination Centre Discover Portal NIHR DC Discover Carefully managed antibiotic use could halve antibiotic-resistant infections Published on 17 October 2017 Antibiotic stewardship programmes could halve the number of infections due to antibiotic-resistant bacteria compared with unguided prescribing. Combining these programmes (...) with hand hygiene, such as washing hands with soap and water and using alcohol-based hand-rubs, could reduce antibiotic resistance further. Bacterial resistance to existing antibiotics is increasing, and for some conditions, there aren’t enough new antibiotics available to treat infections caused by resistant bacteria. Antibiotic stewardship involves promoting the appropriate use of antibiotics according to local resistance patterns and aims to give patients the right antibiotics for the right length

NIHR Dissemination Centre2018

16. Long-term antibiotics likely to reduce risk of recurrent cellulitis

Long-term antibiotics likely to reduce risk of recurrent cellulitis Signal - Long-term antibiotics likely to reduce risk of recurrent cellulitis Dissemination Centre Discover Portal NIHR DC Discover Long-term antibiotics likely to reduce risk of recurrent cellulitis Published on 17 October 2017 Antibiotics may reduce the risk of leg cellulitis by about two thirds, in adults who have had at least two previous episodes, but only while they take the antibiotics. There is limited evidence measuring (...) the efficacy of other forms of prevention. A review of five studies showed that the risk of developing repeated cellulitis was reduced in participants who were taking long-term (more than six months) penicillin or erythromycin, compared with a control group. Once the antibiotic course had finished, participants’ risk of recurrent cellulitis was no different from the control group. Cellulitis is a bacterial skin infection that spreads and worsens quickly. Risk of recurrence is high in people

NIHR Dissemination Centre2018

17. Antibiotics by injection into the eye can prevent severe infection following cataract surgery

Antibiotics by injection into the eye can prevent severe infection following cataract surgery Signal - Antibiotics by injection into the eye can prevent severe infection following cataract surgery Dissemination Centre Discover Portal NIHR DC Discover Antibiotics by injection into the eye can prevent severe infection following cataract surgery Published on 11 April 2017 Injecting the antibiotics vancomycin or moxifloxacin into the eyeball after eye surgery can reduce the risk of developing (...) severe infection inside the eye (endophthalmitis) compared to other routes. Cefuroxime is currently the antibiotic of choice for this in the UK, but researchers wanted to see if drugs with lower rates of resistance might also be effective. A of 34 studies, mostly observational studies with nine randomised controlled trials (RCTs), explored the effects of different types of antibiotic regimens on the risk of endophthalmitis in people who had received eye surgery. There were no randomised trials

NIHR Dissemination Centre2018

18. Giving immediate antibiotics reduces deaths from sepsis

Giving immediate antibiotics reduces deaths from sepsis Signal - Giving immediate antibiotics reduces deaths from sepsis Dissemination Centre Discover Portal NIHR DC Discover Giving immediate antibiotics reduces deaths from sepsis Published on 18 April 2017 Giving immediate antibiotics (defined as within one hour) when people present to emergency departments with suspected sepsis reduces their risk of dying by a third compared with later administration. This meta-analysis of observational data (...) from 23,596 people in emergency department settings confirmed that giving antibiotics within one hour was linked to a lower risk of in-hospital mortality compared with giving antibiotics later. This adds weight to recommendations from NICE and other organisations that antibiotics should be administered straight away in people with suspected sepsis. However, in practice up to a third of people in the UK do not receive antibiotics within the hour. NHS England and the UK Sepsis Trust have to encourage

NIHR Dissemination Centre2018

19. Nitrofurantoin is as effective as other long-term antibiotics for preventing recurrent urinary tract infections

Nitrofurantoin is as effective as other long-term antibiotics for preventing recurrent urinary tract infections Signal - Nitrofurantoin is as effective as other long-term antibiotics for preventing recurrent urinary tract infections Dissemination Centre Discover Portal NIHR DC Discover Nitrofurantoin is as effective as other long-term antibiotics for preventing recurrent urinary tract infections Published on 19 December 2016 The antibiotic nitrofurantoin works as well as other long-term (...) antibiotics for preventing recurrent urinary tract infections in women. However gastrointestinal side effects were more common in people on nitrofurantoin. The potential for inducing less antibiotic resistance compared to trimethoprim is a potential advantage of nitrofurantoin but this wasn’t a specified outcome for this review. This review of 12 trials, with 1,063 women, compared nitrofurantoin with other antibiotics such as trimethoprim, or oestrogen cream. It was hoped that this older antibiotic could

NIHR Dissemination Centre2018

20. Central lines coated with antibiotics reduce bloodstream infections in children

Central lines coated with antibiotics reduce bloodstream infections in children Signal - Central lines coated with antibiotics reduce bloodstream infections in children Dissemination Centre Discover Portal NIHR DC Discover Central lines coated with antibiotics reduce bloodstream infections in children Published on 10 May 2016 Children in intensive care had lower rates of infection when using antibiotic coated central lines (also called central venous catheters) compared to standard central (...) lines or those coated with heparin – an anti-clotting agent. Antibiotic or heparin coated central lines have long been used in adults to reduce catheter-associated bloodstream infections, but evidence for benefits in children was lacking. This NIHR funded trial provides evidence that use of antibiotic coated central lines could reduce bloodstream infections in paediatric intensive care units. The researchers say cost-effectiveness, based on six-month hospital resource data, will be reported

NIHR Dissemination Centre2018