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Latest & greatest articles for antibiotics
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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.
Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Antibiotics alter the microbial balance commonly resulting in antibiotic-associated diarrhea (AAD). Probiotics may prevent AAD via providing gut barrier, restoration of the gut microflora, and other potential mechanisms of action.The primary objectives were to assess the efficacy and safety of probiotics (any specified strain or dose) used for the prevention of AAD in children.MEDLINE, Embase, CENTRAL, CINAHL (...) , and the Web of Science (inception to 28 May 2018) were searched along with registers including the ISRCTN and Clinicaltrials.gov. We also searched the NICE Evidence Services database as well as reference lists from relevant articles.Randomized, parallel, controlled trials in children (0 to 18 years) receiving antibiotics, that compare probiotics to placebo, active alternative prophylaxis, or no treatment and measure the incidence of diarrhea secondary to antibiotic use were considered for inclusion.Study
Community-based antibiotic delivery for possible serious bacterial infections in neonates in low- and middle-income countries. The recommended management for neonates with a possible serious bacterial infection (PSBI) is hospitalisation and treatment with intravenous antibiotics, such as ampicillin plus gentamicin. However, hospitalisation is often not feasible for neonates in low- and middle-income countries (LMICs). Therefore, alternative options for the management of neonatal PSBI in LMICs (...) needs to be evaluated.To assess the effects of community-based antibiotics for neonatal PSBI in LMICs on neonatal mortality and to assess whether the effects of community-based antibiotics for neonatal PSBI differ according to the antibiotic regimen administered.We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2018, Issue 3), MEDLINE via PubMed (1966 to 16 April 2018), Embase (1980 to 16 April 2018), and CINAHL (1982
Is There a Difference in Infection Risk Between Single and Multiple Doses of Prophylactic Antibiotics? A Meta-analysis The prevention of surgical site infection guidelines issued by the Centers for Disease Control and Prevention (CDC) recently recommended that only a single dose of preoperative antibiotics be administered to patients undergoing clean-contaminated procedures based on data from a variety of surgical disciplines. For orthopaedic procedures, where postoperative infections can have (...) significant consequences, the existing evidence for this recommendation is widely debated.Is there a difference in postoperative infection risk when utilizing a single dose of preoperative antibiotics compared with multiple doses of perioperative antibiotics for orthopaedic procedures where implants are placed?MEDLINE, EMBASE, Google Scholar, and Cochrane were systematically reviewed for randomized controlled trials (RCTs) of a single dose of preoperative antibiotics compared with pre- and postoperative
Proposals for a more effective antibiotic policy in Belgium 2019 www.kce.fgov.be KCE REPORT 311 PROPOSALS FOR A MORE EFFECTIVE ANTIBIOTIC POLICY IN BELGIUM 2019 www.kce.fgov.be KCE REPORT 311 HEALTH SERVICES RESEARCH PROPOSALS FOR A MORE EFFECTIVE ANTIBIOTIC POLICY IN BELGIUM ROOS LEROY, WENDY CHRISTIAENS, CHARLINE MAERTENS DE NOORDHOUT, GERMAINE HANQUET COLOPHON Title: Proposals for a more effective antibiotic policy in Belgium Authors: Roos Leroy (KCE), Wendy Christiaens (KCE), Charline (...) of antibiotic use in animals), Frédéric Frippiat (Antibiotics dosage in CHU Liège, funded by CHU Liège), Jacques Mainil (Project FOD – SPF Health Care: Emergence and decline of classical beta-lactamases, of extended spectrum beta lactamases and of carbapenemases amongst coliform bacteria from ruminants: gene identification, antibody neutralization and strain survival), Léonard Théron (Project LAECEA, mastitis epidemic) A grant, fees or funds for a member of staff or another form of compensation
Long-term antibiotics for preventing recurrent urinary tract infection in children. Urinary tract infection (UTI) is common in children. Symptoms include fever, lethargy, anorexia, and vomiting. UTI is caused by Escherichia coli in over 80% of cases and treatment is a course of antibiotics. Due to acute illness caused by UTI and the risk of pyelonephritis-induced permanent kidney damage, many children are given long-term (several months to 2 years) antibiotics aimed at preventing recurrence (...) . This is the third update of a review first published in 2001 and updated in 2006, and 2011.To assess whether long-term antibiotic prophylaxis was more effective than placebo/no treatment in preventing recurrence of UTI in children, and if so which antibiotic in clinical use was the most effective. We also assessed the harms of long-term antibiotic treatment.We searched the Cochrane Kidney and Transplant Register of Studies up to 30 July 2018 through contact with the Cochrane Information Specialist using search
A Randomized Trial of Prophylactic Antibiotics for Miscarriage Surgery. Surgical intervention is needed in some cases of spontaneous abortion to remove retained products of conception. Antibiotic prophylaxis may reduce the risk of pelvic infection, which is an important complication of this surgery, particularly in low-resource countries.We conducted a double-blind, placebo-controlled, randomized trial investigating whether antibiotic prophylaxis before surgery to complete a spontaneous (...) of these features and the clinically identified need to administer antibiotics. The definition of pelvic infection was changed before the unblinding of the data; the original strict definition was two or more of the clinical features, without reference to the administration of antibiotics.We enrolled 3412 patients in Malawi, Pakistan, Tanzania, and Uganda. A total of 1705 patients were assigned to receive antibiotics and 1707 to receive placebo. The risk of pelvic infection was 4.1% (68 of 1676 pregnancies
Antibiotic Treatment and Appendectomy for Uncomplicated Acute Appendicitis in Adults and Children: A Systematic Review and Meta-analysis The aim of this meta-analysis was to summarize the current available evidence on nonoperative management (NOM) with antibiotics for uncomplicated appendicitis, both in adults and children.Although earlier meta-analyses demonstrated that NOM with antibiotics may be an acceptable treatment strategy for patients with uncomplicated appendicitis, evidence (...) is limited by conflicting results.Systematic literature search was performed using MEDLINE, the Cochrane Central Register of Controlled Trials, and EMBASE databases for randomized and nonrandomized studies comparing antibiotic therapy (AT) and surgical therapy-appendectomy (ST) for uncomplicated appendicitis. Literature search was completed in August 2018.Twenty studies comparing AT and ST qualified for inclusion in the quantitative synthesis. In total, 3618 patients were allocated to AT (n = 1743) or ST
Antibiotic management of urinary tract infection in elderly patients in primary care and its association with bloodstream infections and all cause mortality: population based cohort study. To evaluate the association between antibiotic treatment for urinary tract infection (UTI) and severe adverse outcomes in elderly patients in primary care.Retrospective population based cohort study.Clinical Practice Research Datalink (2007-15) primary care records linked to hospital episode statistics (...) and death records in England.157 264 adults aged 65 years or older presenting to a general practitioner with at least one diagnosis of suspected or confirmed lower UTI from November 2007 to May 2015.Bloodstream infection, hospital admission, and all cause mortality within 60 days after the index UTI diagnosis.Among 312 896 UTI episodes (157 264 unique patients), 7.2% (n=22 534) did not have a record of antibiotics being prescribed and 6.2% (n=19 292) showed a delay in antibiotic prescribing. 1539
Duration of antibiotic treatment for common infections in English primary care: cross sectional analysis and comparison with guidelines. To evaluate the duration of prescriptions for antibiotic treatment for common infections in English primary care and to compare this with guideline recommendations.Cross sectional study.General practices contributing to The Health Improvement Network database, 2013-15.931 015 consultations that resulted in an antibiotic prescription for one of several (...) indications: acute sinusitis, acute sore throat, acute cough and bronchitis, pneumonia, acute exacerbation of chronic obstructive pulmonary disease (COPD), acute otitis media, acute cystitis, acute prostatitis, pyelonephritis, cellulitis, impetigo, scarlet fever, and gastroenteritis.The main outcomes were the percentage of antibiotic prescriptions with a duration exceeding the guideline recommendation and the total number of days beyond the recommended duration for each indication.The most common reasons
Antibiotic treatment for newborns with congenital syphilis. Congenital syphilis continues to be a substantial public health problem in many parts of the world. Since the first use of penicillin for the treatment of syphilis in 1943, which was a notable early success, it has remained the preferred and standard treatment including for congenital syphilis. However, the treatment of congenital syphilis is largely based on clinical experience and there is extremely limited evidence on the optimal (...) dose or duration of administration of penicillin or the use of other antibiotics.To assess the effectiveness and safety of antibiotic treatment for newborns with confirmed, highly probable and possible congenital syphilis.We searched the Cochrane STI Group Specialized Register, CENTRAL, MEDLINE, Embase, LILACS, WHO ICTRP, ClinicalTrials.gov and Web of Science to 23 May 2018. We also handsearched conference proceedings, contacted trial authors and reviewed the reference lists of retrieved
Effectiveness and safety of electronically delivered prescribing feedback and decision support on antibiotic use for respiratory illness in primary care: REDUCE cluster randomised trial. 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.Open label, two arm, cluster randomised controlled trial.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 2017.79 general practices (582 675 patient years) randomised (1:1) to antimicrobial stewardship (AMS) intervention or usual care.AMS intervention comprised a brief training webinar, automated monthly feedback reports of antibiotic prescribing, and electronic decision support tools to inform appropriate prescribing over 12 months. Intervention components were delivered
Antibiotics for induction and maintenance of remission in Crohn's disease. Several antibiotics have been evaluated in Crohn's disease (CD), however randomised controlled trials (RCTs) have produced conflicting results.To assess the efficacy and safety of antibiotics for induction and maintenance of remission in CD.We searched MEDLINE, Embase, CENTRAL, the Cochrane IBD Group Specialized Register and Clinicaltrials.gov database from inception to 28 February 2018. We also searched reference lists (...) and conference proceedings.RCTs comparing antibiotics to placebo or an active comparator in adult (> 15 years) CD patients were considered for inclusion.Two authors screened search results and extracted data. Bias was evaluated using the Cochrane risk of bias tool. The primary outcomes were failure to achieve clinical remission and relapse. Secondary outcomes included clinical response, endoscopic response, endoscopic remission, endoscopic relapse, histologic response, histologic remission, adverse events
Antibiotic-Loaded Collagen Sponges in Clinical Treatment of Chronic Osteomyelitis: A Systematic Review Chronic osteomyelitis is caused by bacterial infection of the bone and is a major problem in orthopaedic surgery. Treatment of chronic osteomyelitis requires surgical debridement accompanied by local and systemic administration of antibiotics. A widely established biodegradable local antibiotic carrier is antibiotic-loaded collagen sponges (fleeces). These sponges are commonly used (...) in the treatment of chronic osteomyelitis, but a systematic review of their clinical efficacy and assessment of the quality of evidence have not been conducted, to our knowledge.This systematic review, performed according to the PRISMA statement, examined the clinical efficacy of and quality of evidence regarding different antibiotic-loaded collagen sponges in the clinical treatment of chronic osteomyelitis. Clinical efficacy was defined as eradication of infection with bone and wound-healing. In addition
There?s Pus About, So Are Antibiotics In or Out? Adding antibiotics for abscess management Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 5,000 family physicians, family medicine residents, and medical students in Alberta. Established over sixty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education and primary care (...) research. www.acfp.ca January 21, 2019 There’s Pus About, So Are Antibiotics In or Out? Adding antibiotics for abscess management Clinical Question: Does the addition of antibiotics to incision and drainage improve cure rates in single, uncomplicated skin abscesses? Bottom Line: Adding antibiotics that cover MRSA during incision and drainage for a small abscess increases the cure rate from 85% to 92%, meaning an additional one in 15 patients will be cured compared to placebo at one month. Approximately
Prescribing anti-inflammatories for urine infection reduces antibiotic use but increases complication risk Anti-inflammatories for urine infection reduces antibiotic use but increases complication risk Discover Portal Discover Portal Prescribing anti-inflammatories for urine infection reduces antibiotic use but increases complication risk Published on 5 June 2018 doi: 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 don’t indicate that a switch
Probiotics can prevent bacterial diarrhoea in hospital patients receiving antibiotics Probiotics to prevent diarrhoea caused by C. difficile Discover Portal Discover Portal Probiotics can prevent bacterial diarrhoea in hospital patients receiving antibiotics Published on 1 May 2018 doi: 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 these effects. This updated Cochrane review pooled 39 trials
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 Discover Portal Discover Portal 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. As overall reported health
Adding the extra antibiotic rifampicin did not improve cure rates after sepsis Adding the extra antibiotic rifampicin did not improve cure rates after sepsis Discover Portal Discover Portal Adding the extra antibiotic rifampicin did not improve cure rates after sepsis Published on 17 April 2018 doi: 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-threatening and one