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. Effectiveness and safety of electronically delivered prescribing feedback and decision support on antibiotic use for respiratory illness in primary care: REDUCE cluster randomised trial. (PubMed)

Effectiveness and safety of electronically delivered prescribing feedback and decision support on antibiotic use for respiratory illness in primary care: REDUCE cluster randomised trial. OBJECTIVES: To evaluate the effectiveness and safety at population scale of electronically delivered prescribing feedback and decision support interventions at reducing antibiotic prescribing for self limiting respiratory tract infections. DESIGN: Open label, two arm, cluster randomised controlled trial (...) . SETTING: UK general practices in the Clinical Practice Research Datalink, randomised between 11 November 2015 and 9 August 2016, with final follow-up on 9 August 2017. PARTICIPANTS: 79 general practices (582 675 patient years) randomised (1:1) to antimicrobial stewardship (AMS) intervention or usual care. INTERVENTIONS: AMS intervention comprised a brief training webinar, automated monthly feedback reports of antibiotic prescribing, and electronic decision support tools to inform appropriate

2019 BMJ

2. Adding the extra antibiotic rifampicin did not improve cure rates after sepsis

Adding the extra antibiotic rifampicin did not improve cure rates after sepsis Adding the extra antibiotic rifampicin did not improve cure rates after sepsis Dissemination Centre Discover Portal NIHR DC Discover Adding the extra antibiotic rifampicin did not improve cure rates after sepsis Published on 17 April 2018 Adding the antibiotic rifampicin did not improve cure rates or reduce deaths for people with bacterial blood infections caused by Staphylococcus aureus . It increased the risk (...) of adverse reactions requiring a change in treatment and the chances of drug interactions. This NIHR-funded trial is the largest to date on adding rifampicin to standard antibiotic therapy. The study included 770 people in 29 UK hospitals. Half were assigned to 14 days of treatment with rifampicin on top of their existing antibiotic regime. Rifampicin could be either oral or intravenous. Share your views on the research. Why was this study needed? Blood stream infections with S. aureus are life

2019 NIHR Dissemination Centre

3. 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

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2019 NIHR Dissemination Centre

4. 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

2019 NIHR Dissemination Centre

5. 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

2019 NIHR Dissemination Centre

6. 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

2019 NIHR Dissemination Centre

7. 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

2019 NIHR Dissemination Centre

8. 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

2019 NIHR Dissemination Centre

9. Antibiotics are not necessary for preventing infections following simple hand surgery

Antibiotics are not necessary for preventing infections following simple hand surgery Signal - Antibiotics are not necessary for preventing infections following simple hand surgery Dissemination Centre Discover Portal NIHR DC Discover Antibiotics are not necessary for preventing infections following simple hand surgery Published on 24 May 2016 Antibiotics did not significantly reduce the number of infections in people with clean wounds who had simple hand surgery, this review found. NICE (...) guidance, published in 2008, recommends that antibiotics are not prescribed for uncomplicated surgery where the wound is clean. The findings of this review support this recommendation. This work also fits with NICE 2015 guidance on antimicrobial stewardship, providing information to improve antibiotic prescribing decisions. Many of the studies included in this review may have suffered from bias, so the results should be viewed with some caution. Share your views on the research. Why was this study

2019 NIHR Dissemination Centre

10. 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

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2019 NIHR Dissemination Centre

11. Education targeted at both parents and GPs reduces antibiotic prescribing for children

Education targeted at both parents and GPs reduces antibiotic prescribing for children Signal - Education targeted at both parents and GPs reduces antibiotic prescribing for children Dissemination Centre Discover Portal NIHR DC Discover Education targeted at both parents and GPs reduces antibiotic prescribing for children Published on 30 August 2016 Interventions aimed at improving communication between GPs and parents could reduce unnecessary antibiotic prescribing for childhood upper (...) respiratory infections, such as the common cold. Inappropriate use of antibiotics has contributed to antibiotic resistance, resulting in impossible or difficult to treat infections. Parents, as well as GPs, influence the decision to prescribe antibiotics. Educational interventions that target both groups appear to be more effective at reducing prescriptions than those focussing on either group on their own. This information came from a systematic review of 12 studies conducted in high-income countries

2019 NIHR Dissemination Centre

12. Antibiotics for eczema that looks infected may be unnecessary in some cases

Antibiotics for eczema that looks infected may be unnecessary in some cases Signal - Antibiotics for eczema that looks infected may be unnecessary in some cases Dissemination Centre Discover Portal NIHR DC Discover Antibiotics for eczema that looks infected may be unnecessary in some cases Published on 26 July 2016 This trial found that when treating childhood eczema that clinically looked suspicious of moderate infection, adding antibiotic tablets or creams to the usual treatment of oils (...) , lotions, creams and corticosteroids was not clearly beneficial. When eczema becomes infected, NICE recommends using antibiotics that are applied to the skin for small-scale infections and oral antibiotics for the treatment of widespread infection. Reducing the use of ineffective treatments reduce harm to patients and could also reduce the development of antimicrobial resistance so it is important to know how strong the evidence is that supports the use of antibiotics when eczema looks as if it might

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2019 NIHR Dissemination Centre

13. 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

2019 NIHR Dissemination Centre

14. 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

2019 NIHR Dissemination Centre

15. 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

2019 NIHR Dissemination Centre

16. 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

2019 NIHR Dissemination Centre

17. 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

2019 NIHR Dissemination Centre

18. Probiotics can prevent bacterial diarrhoea in hospital patients receiving antibiotics

Probiotics can prevent bacterial diarrhoea in hospital patients receiving antibiotics Probiotics can prevent bacterial diarrhoea in hospital patients receiving antibiotics Dissemination Centre Discover Portal NIHR DC Discover Probiotics can prevent bacterial diarrhoea in hospital patients receiving antibiotics Published on 1 May 2018 Giving probiotics to people taking antibiotics reduces the chance of them developing diarrhoea caused by Clostridium difficile ( C. difficile ) bacteria by 60 (...) %. One case of Clostridium-associated diarrhoea was prevented for every 42 people receiving probiotics. They appear to work best for patients at more than 5% risk of Clostridium infection. When antibiotics disturb healthy gut bacteria, Clostridium bacteria may multiply to toxic levels, causing diarrhoea and serious intestinal complications. Probiotics can be found in dietary supplements or yoghurts but are increasingly sold as capsules and contain live bacteria or yeast that may counteract

2019 NIHR Dissemination Centre

19. Prescribing anti-inflammatories for urine infection reduces antibiotic use but increases complication risk

Prescribing anti-inflammatories for urine infection reduces antibiotic use but increases complication risk Prescribing anti-inflammatories for urine infection reduces antibiotic use but increases complication risk Dissemination Centre Discover Portal NIHR DC Discover Prescribing anti-inflammatories for urine infection reduces antibiotic use but increases complication risk Published on 5 June 2018 Urinary tract infection symptoms resolved by three days for 80% of women given antibiotics compared (...) with 54% given anti-inflammatories. Anti-inflammatories reduced antibiotic use, but 5% of women developed more severe infection of the kidneys. Urinary infections are the second most common reason for prescribing antibiotics in general practice, after respiratory infection. As such, this use may be contributing to increasing antibiotic resistance. This Swiss trial provided an important head-to-head comparison of antibiotic treatment with the anti-inflammatory diclofenac in 253 women. The findings

2019 NIHR Dissemination Centre

20. Daily low-dose antibiotics halve urinary tract infections in people who self-catheterise

Daily low-dose antibiotics halve urinary tract infections in people who self-catheterise Daily low-dose antibiotics halve urinary tract infections in people who self-catheterise Dissemination Centre Discover Portal NIHR DC Discover Daily low-dose antibiotics halve urinary tract infections in people who self-catheterise Published on 14 August 2018 doi: People who perform clean intermittent self-catheterisation can reduce symptomatic urinary tract infections from two per year to one by taking (...) daily low-dose antibiotics. This NIHR-funded trial randomised 404 adults in the UK who perform the procedure for a variety of reasons to either daily oral low-dose antibiotics or no prophylaxis. All had a recent history of urinary tract infection. Although prophylactic antibiotics halved infection rates, it increased antimicrobial resistance compared with the control group who took short courses of antibiotics for each infection. This has implications for the individual and wider population

2019 NIHR Dissemination Centre