Latest & greatest articles for antibiotics

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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

81. Long-Term Effects of Omitting Antibiotics in Uncomplicated Acute Diverticulitis

Long-Term Effects of Omitting Antibiotics in Uncomplicated Acute Diverticulitis 29700480 2018 05 11 1572-0241 2018 May 11 The American journal of gastroenterology Am. J. Gastroenterol. Long-Term Effects of Omitting Antibiotics in Uncomplicated Acute Diverticulitis. 10.1038/s41395-018-0030-y Traditionally uncomplicated acute diverticulitis was routinely treated with antibiotics, although evidence for this strategy was lacking. Recently, two randomized clinical trials (AVOD trial and DIABOLO (...) trial) published short-term results of omitting antibiotics compared to routine antibiotic treatment. Both showed no significant differences regarding recovery from the initial episode, as well as rates of complicated or recurrent diverticulitis and sigmoid resection. However, both studies showed a trend of higher rates of sigmoid resection in the observational groups. Here, the long-term effects of omitting antibiotics in first episode uncomplicated acute diverticulitis were assessed. A total

2018 EvidenceUpdates

82. Preventive Antibiotics in Stroke Study (PASS): A cost-effectiveness study

Preventive Antibiotics in Stroke Study (PASS): A cost-effectiveness study 29626176 2018 05 01 1526-632X 90 18 2018 May 01 Neurology Neurology Preventive Antibiotics in Stroke Study (PASS): A cost-effectiveness study. e1553-e1560 10.1212/WNL.0000000000005412 To evaluate the cost-effectiveness of preventive ceftriaxone vs standard stroke unit care without preventive antimicrobial therapy in acute stroke patients. In this multicenter, randomized, open-label trial with masked endpoint assessment

2018 EvidenceUpdates

83. Prophylactic antibiotics at the time of elective cholecystectomy are effective in reducing the post-operative infective complications: a systematic review and meta-analysis (PubMed)

Prophylactic antibiotics at the time of elective cholecystectomy are effective in reducing the post-operative infective complications: a systematic review and meta-analysis 29780900 2018 11 14 2415-1289 3 2018 Translational gastroenterology and hepatology Transl Gastroenterol Hepatol Prophylactic antibiotics at the time of elective cholecystectomy are effective in reducing the post-operative infective complications: a systematic review and meta-analysis. 22 10.21037/tgh.2018.04.06 The objective (...) of this article is to evaluate the role of prophylactic antibiotics in preventing the infective complications in patients undergoing elective laparoscopic cholecystectomy (ELC). A systematic review of the literature on the published randomized, controlled reporting the role of prophylactic antibiotics in preventing the infective complications in patients undergoing ELC was undertaken using the principles of meta-analysis. Twenty-five RCTs on 6,138 patients evaluating the infective complications in patients

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2018 Translational gastroenterology and hepatology

84. 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 NIHR DC | 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

2018 NIHR Dissemination Centre

85. Computerised decision support can improve antibiotic prescribing in hospitals

Computerised decision support can improve antibiotic prescribing in hospitals NIHR DC | 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

2018 NIHR Dissemination Centre

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

Blood test could shorten antibiotic treatment in newborns with suspected sepsis NIHR DC | 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

2018 NIHR Dissemination Centre

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

Long-term antibiotics likely to reduce risk of recurrent cellulitis NIHR DC | Signal - Long-term antibiotics likely to reduce risk of recurrent cellulitis Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal 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

2018 NIHR Dissemination Centre

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

Carefully managed antibiotic use could halve antibiotic-resistant infections NIHR DC | Signal - Carefully managed antibiotic use could halve antibiotic-resistant infections Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal 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

2018 NIHR Dissemination Centre

89. 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 NIHR DC | 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

2018 NIHR Dissemination Centre

90. 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 NIHR DC | 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

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2018 NIHR Dissemination Centre

91. Giving antibiotics immediately reduces deaths from sepsis

Giving antibiotics immediately reduces deaths from sepsis NIHR DC | Signal - Giving immediate antibiotics reduces deaths from sepsis Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal 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

2018 NIHR Dissemination Centre

92. 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 NIHR DC | Signal - Antibiotics by injection into the eye can prevent severe infection following cataract surgery Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal 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

2018 NIHR Dissemination Centre

93. 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 NIHR DC | Signal - Nitrofurantoin is as effective as other long-term antibiotics for preventing recurrent urinary tract infections Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal 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

2018 NIHR Dissemination Centre

94. New evidence available on corticosteroids added to antibiotics in severe pneumonia

New evidence available on corticosteroids added to antibiotics in severe pneumonia NIHR DC | Signal - New evidence available on corticosteroids added to antibiotics in severe pneumonia Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal New evidence available on corticosteroids added to antibiotics in severe pneumonia Published on 9 November 2015 For adults admitted to hospital with severe pneumonia, this review found that adding corticosteroids to the usual antibiotic treatment (...) in terms of treatment costs and loss of life: between 22 and 42% of adults with community acquired pneumonia are admitted to hospital and 5 to 14% of people with more severe illness die from the condition. Antibiotics are the main treatment for pneumonia. A 2011 systematic review of six small trials found that adding corticosteroid treatment increased speed of recovery slightly, but the evidence was not strong. The current review aimed to update the evidence on benefits and potential side effects

2018 NIHR Dissemination Centre

95. Preventive antibiotics for gallbladder surgery not required in those at low or moderate risk

Preventive antibiotics for gallbladder surgery not required in those at low or moderate risk NIHR DC | Signal - Preventive antibiotics for gallbladder surgery not required in those at low or moderate risk Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal Preventive antibiotics for gallbladder surgery not required in those at low or moderate risk Published on 4 December 2015 Guidelines recommend that antibiotics are only prescribed before gallbladder keyhole surgery (laparoscopy (...) ) to those at increased risk of infection. However, 36% of surgeons still prescribe them. This systematic review found that antibiotics given before removing the gall bladder by keyhole surgery for gallstone colic did not reduce the rate of surgical site infection, distant site infections or hospital-acquired infections. Though adverse effects due to the antibiotics were uncommon, inappropriate use adds to the growing problem of antimicrobial resistance. The review findings support NICE and the Royal

2018 NIHR Dissemination Centre

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

Central lines coated with antibiotics reduce bloodstream infections in children NIHR DC | Signal - Central lines coated with antibiotics reduce bloodstream infections in children Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal 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

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2018 NIHR Dissemination Centre

97. Shared decision making in primary care can reduce antibiotic prescribing

Shared decision making in primary care can reduce antibiotic prescribing NIHR DC | Signal - Shared decision making in primary care can reduce antibiotic prescribing Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal Shared decision making in primary care can reduce antibiotic prescribing Published on 26 January 2016 Strategies, known as shared decision making, reduced antibiotic prescribing for people with acute respiratory infections by almost 40% in the short term (up to six (...) . Four studies included in this review were from the UK and the other six were from high-income European countries and Canada, so the findings are applicable to the UK. There is insufficient evidence about the long term effect (up to one year and beyond) of the strategies used to facilitate shared decision making, so it is not known whether they could reverse community-level antibiotic resistance trends. It is likely that multiple approaches will be needed. Why was this study needed? Antibiotic

2018 NIHR Dissemination Centre

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

Antibiotics for eczema that looks infected may be unnecessary in some cases NIHR DC | Signal - Antibiotics for eczema that looks infected may be unnecessary in some cases Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal 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

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2018 NIHR Dissemination Centre

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

Education targeted at both parents and GPs reduces antibiotic prescribing for children NIHR DC | Signal - Education targeted at both parents and GPs reduces antibiotic prescribing for children Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal 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

2018 NIHR Dissemination Centre

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

Antibiotics are not necessary for preventing infections following simple hand surgery NIHR DC | Signal - Antibiotics are not necessary for preventing infections following simple hand surgery Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal 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. Why was this study needed? Infection

2018 NIHR Dissemination Centre