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

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

Central lines coated with antibiotics reduce bloodstream infections in children Central lines coated with antibiotics reduce bloodstream infections in children Discover Portal Discover Portal Central lines coated with antibiotics reduce bloodstream infections in children Published on 10 May 2016 doi: 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 elsewhere. Tis evidence is needed

2019 NIHR Dissemination Centre

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

Antibiotics are not necessary for preventing infections following simple hand surgery Antibiotics are not necessary for preventing infections following simple hand surgery Discover Portal Discover Portal Antibiotics are not necessary for preventing infections following simple hand surgery Published on 24 May 2016 doi: 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 needed? Infection following surgery

2019 NIHR Dissemination Centre

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

Long-term antibiotics likely to reduce risk of recurrent cellulitis Long-term antibiotics likely to reduce risk of recurrent cellulitis Discover Portal Discover Portal Long-term antibiotics likely to reduce risk of recurrent cellulitis Published on 17 October 2017 doi: 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 with a predisposing condition

2019 NIHR Dissemination Centre

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

Carefully managed antibiotic use could halve antibiotic-resistant infections Carefully managed antibiotic use could halve antibiotic-resistant infections Discover Portal Discover Portal Carefully managed antibiotic use could halve antibiotic-resistant infections Published on 17 October 2017 doi: 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 of time and at the correct

2019 NIHR Dissemination Centre

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

Blood test could shorten antibiotic treatment in newborns with suspected sepsis Blood test could shorten antibiotic treatment in newborns with suspected sepsis Discover Portal Discover Portal Blood test could shorten antibiotic treatment in newborns with suspected sepsis Published on 28 November 2017 doi: 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 infection

2019 NIHR Dissemination Centre

66. Computerised decision support can improve antibiotic prescribing in hospitals

Computerised decision support can improve antibiotic prescribing in hospitals Computerised decision support can improve antibiotic prescribing in hospitals Discover Portal Discover Portal Computerised decision support can improve antibiotic prescribing in hospitals Published on 28 November 2017 doi: 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 be a useful component

2019 NIHR Dissemination Centre

67. 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 A strategy of 'delayed antibiotic prescribing' for respiratory infections may reduce antibiotic use Discover Portal Discover Portal A strategy of 'delayed antibiotic prescribing' for respiratory infections may reduce antibiotic use Published on 19 December 2017 doi: 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 antibiotics made little difference

2019 NIHR Dissemination Centre

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

Study shows no benefit of an antibiotic for acute asthma Study shows no benefit of an antibiotic for acute asthma Discover Portal Discover Portal Study shows no benefit of an antibiotic for acute asthma Published on 21 December 2016 doi: 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 used. This raises questions

2019 NIHR Dissemination Centre

69. 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 Nitrofurantoin is as effective as other long-term antibiotics for preventing recurrent urinary tract infections Discover Portal Discover Portal Nitrofurantoin is as effective as other long-term antibiotics for preventing recurrent urinary tract infections Published on 19 December 2016 doi: 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 be a first-line strategy

2019 NIHR Dissemination Centre

70. 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 Intravenous antibiotics, administered over 3 hours, are linked to lower death rates in sepsis Discover Portal Discover Portal Intravenous antibiotics, administered over 3 hours, are linked to lower death rates in sepsis Published on 31 January 2018 doi: 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 patients should be given

2019 NIHR Dissemination Centre

71. 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 Blood test reduces mortality and shortens antibiotic use among adults with chest infection Discover Portal Discover Portal Blood test reduces mortality and shortens antibiotic use among adults with chest infection Published on 16 January 2018 doi: 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 and may be continued longer

2019 NIHR Dissemination Centre

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

Education targeted at both parents and GPs reduces antibiotic prescribing for children Education targeted at both parents and GPs reduces antibiotic prescribing for children Discover Portal Discover Portal Education targeted at both parents and GPs reduces antibiotic prescribing for children Published on 30 August 2016 doi: 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, one in the UK. It could be used

2019 NIHR Dissemination Centre

73. Giving immediate antibiotics reduces deaths from sepsis

Giving immediate antibiotics reduces deaths from sepsis Giving immediate antibiotics reduces deaths from sepsis Discover Portal Discover Portal Giving immediate antibiotics reduces deaths from sepsis Published on 18 April 2017 doi: 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 recently launched a campaign

2019 NIHR Dissemination Centre

74. 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 Antibiotics by injection into the eye can prevent severe infection following cataract surgery Discover Portal Discover Portal Antibiotics by injection into the eye can prevent severe infection following cataract surgery Published on 11 April 2017 doi: 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 of vancomycin or moxifloxacin injections

2019 NIHR Dissemination Centre

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

Antibiotics for eczema that looks infected may be unnecessary in some cases Antibiotics for eczema that looks infected may be unnecessary in some cases Discover Portal Discover Portal Antibiotics for eczema that looks infected may be unnecessary in some cases Published on 26 July 2016 doi: 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 be infected. There are some

2019 NIHR Dissemination Centre

76. 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 Discover Portal Discover Portal 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 indicate that a successful implementation

2019 NIHR Dissemination Centre

77. Antibiotics may be an alternative first-line treatment for uncomplicated appendicitis

Antibiotics may be an alternative first-line treatment for uncomplicated appendicitis Antibiotics may be an alternative first-line treatment for uncomplicated appendicitis Discover Portal Discover Portal Antibiotics may be an alternative first-line treatment for uncomplicated appendicitis Published on 22 January 2019 doi: Appendicectomy surgery could potentially be avoided for around 60% of adults with uncomplicated appendicitis if they receive antibiotics first. Adults in Finland (...) with appendicitis were randomised to have appendicectomy or a course of antibiotics. In 6 out of 10 the appendicitis settled and did not return over the five years they were followed. Of those who did go on to need surgery most did so in the first year. If the findings from the study could be applied to the UK, it is estimated that up to 24,000 appendicectomies might be avoided in England each year. In the UK, appendicitis is usually managed by appendicectomy, so shifting to antibiotic therapy as a first choice

2019 NIHR Dissemination Centre

78. Antibiotics for treating urogenital Chlamydia trachomatis infection in men and non-pregnant women. Full Text available with Trip Pro

Antibiotics for treating urogenital Chlamydia trachomatis infection in men and non-pregnant women. The genital infection caused by Chlamydia trachomatis (CT) is a common sexually transmitted infection (STI) globally. The infection is mainly asymptomatic in women, thus it can produce infertility and chronic pelvic pain. In men infection is mainly symptomatic, but can evolve to prostatitis. Clinical practice guidelines for CT urogenital infections do not give any specific recommendation about (...) which antibiotic use as first option OBJECTIVES: To assess the efficacy and safety of antibiotic treatment for CT genital infection in men and non-pregnant women.The Cochrane Sexually Transmitted Infections' (STI) Information Specialist developed the electronic searches in electronic databases (CENTRAL, MEDLINE, Embase and LILACS), and trials registers. We searched studies published from inception to June 2018.We included parallel, randomised controlled trials (RCTs) of men, and sexually-active, non

2019 Cochrane

79. Adverse events in people taking macrolide antibiotics versus placebo for any indication. Full Text available with Trip Pro

Adverse events in people taking macrolide antibiotics versus placebo for any indication. Macrolide antibiotics (macrolides) are among the most commonly prescribed antibiotics worldwide and are used for a wide range of infections. However, macrolides also expose people to the risk of adverse events. The current understanding of adverse events is mostly derived from observational studies, which are subject to bias because it is hard to distinguish events caused by antibiotics from events caused (...) by the diseases being treated. Because adverse events are treatment-specific, rather than disease-specific, it is possible to increase the number of adverse events available for analysis by combining randomised controlled trials (RCTs) of the same treatment across different diseases.To quantify the incidences of reported adverse events in people taking macrolide antibiotics compared to placebo for any indication.We searched the Cochrane Central Register of Controlled Trials (CENTRAL), which includes

2019 Cochrane

80. Appropriateness of outpatient antibiotic prescribing among privately insured US patients: ICD-10-CM based cross sectional study. Full Text available with Trip Pro

Appropriateness of outpatient antibiotic prescribing among privately insured US patients: ICD-10-CM based cross sectional study. To assess the appropriateness of outpatient antibiotic prescribing for privately insured children and non-elderly adults in the US using a comprehensive classification scheme of diagnosis codes in ICD-10-CM (international classification of diseases-clinical modification, 10th revision), which replaced ICD-9-CM in the US on 1 October 2015.Cross sectional (...) study.MarketScan Commercial Claims and Encounters database, 2016.19.2 million enrollees aged 0-64 years.A classification scheme was developed that determined whether each of the 91 738 ICD-10-CM diagnosis codes "always," "sometimes," or "never" justified antibiotics. For each antibiotic prescription fill, this scheme was used to classify all diagnosis codes in claims during a look back period that began three days before antibiotic prescription fills and ended on the day fills occurred. The main outcome

2019 BMJ