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

81. Fluoroquinolone antibiotics: new restrictions and precautions for use due to very rare reports of disabling and potentially long-lasting or irreversible side effects

and tendon rupture report suspected adverse drug reactions to fluoroquinolone antibiotics on the or via the Yellow Card app (download it from the , or ) New restricted indications Fluoroquinolones are antibiotics authorised for serious, life-threatening bacterial infections. As for all antibiotic medicines, consideration should be given to official guidance on the appropriate use of antibacterial agents (see section below on Prescribing guidance). Following an EU-wide review of safety, new restricted (...) Fluoroquinolone antibiotics: new restrictions and precautions for use due to very rare reports of disabling and potentially long-lasting or irreversible side effects Fluoroquinolone antibiotics: new restrictions and precautions for use due to very rare reports of disabling and potentially long-lasting or irreversible side effects - GOV.UK GOV.UK uses cookies to make the site simpler. or Search Fluoroquinolone antibiotics: new restrictions and precautions for use due to very rare reports

2019 MHRA Drug Safety Update

82. Proposals for a more effective antibiotic policy in Belgium

(BAPCOC) 24 1.1.6 Difficult to obtain significant improvements 24 1.2 RESEARCH QUESTIONS & SCOPE 25 1.3 TERMINOLOGY 25 1.4 METHODOLOGY 26 1.5 STRUCTURE OF THE REPORT 26 2 ANTIBIOTIC USE AND ITS LINK WITH ANTIBACTERIAL RESISTANCE 27 2.1 WHAT IS ANTIMICROBIAL RESISTANCE? 27 2.1.1 Antibacterial resistance, a natural phenomenon 27 2.1.2 How do bacteria become resistant? 27 2.1.3 How does antibiotic resistance spread? 28 2.1.4 Multidrug resistant organisms 28 2.1.1 Resistance in community and healthcare (...) . This document is available on the website of the Belgian Health Care Knowledge Centre. KCE Report 311 Antibiotic policy in Belgium 1 ? TABLE OF CONTENTS LIST OF FIGURES 8 LIST OF TABLES 10 LIST OF ABBREVIATIONS 13 ? SCIENTIFIC REPORT 23 1 INTRODUCTION 23 1.1 SHORT DESCRIPTION OF THE PROBLEM 23 1.1.1 Antibiotic resistance 23 1.1.2 Antibiotic use in Belgium 24 1.1.3 The concept of prudent antimicrobial/antibiotic use 24 1.1.4 One Health approach 24 1.1.5 Belgian Antibiotic Policy Coordination Committee

2019 Belgian Health Care Knowledge Centre

83. Effect of prolonged antibiotic treatment on cognition in patients with Lyme borreliosis Full Text available with Trip Pro

Effect of prolonged antibiotic treatment on cognition in patients with Lyme borreliosis To investigate whether longer-term antibiotic treatment improves cognitive performance in patients with persistent symptoms attributed to Lyme borreliosis.Data were collected during the Persistent Lyme Empiric Antibiotic Study Europe (PLEASE) trial, a randomized, placebo-controlled study. Study participants passed performance-validity testing (measure for detecting suboptimal effort) and had persistent (...) treatment with ceftriaxone followed by a 12-week regimen of doxycycline or clarithromycin/hydroxychloroquine did not lead to better cognitive performance compared to a 2-week regimen of ceftriaxone in patients with Lyme disease-attributed persistent symptoms.NCT01207739.This study provides Class II evidence that longer-term antibiotics in patients with borreliosis-attributed persistent symptoms does not increase cognitive performance compared to shorter-term antibiotics.Copyright © 2019 The Author(s

2019 EvidenceUpdates

84. Antibacterial Envelope to Prevent Cardiac Implantable Device Infection. Full Text available with Trip Pro

Antibacterial Envelope to Prevent Cardiac Implantable Device Infection. Infections after placement of cardiac implantable electronic devices (CIEDs) are associated with substantial morbidity and mortality. There is limited evidence on prophylactic strategies, other than the use of preoperative antibiotics, to prevent such infections.We conducted a randomized, controlled clinical trial to assess the safety and efficacy of an absorbable, antibiotic-eluting envelope in reducing the incidence (...) of infection associated with CIED implantations. Patients who were undergoing a CIED pocket revision, generator replacement, or system upgrade or an initial implantation of a cardiac resynchronization therapy defibrillator were randomly assigned, in a 1:1 ratio, to receive the envelope or not. Standard-of-care strategies to prevent infection were used in all patients. The primary end point was infection resulting in system extraction or revision, long-term antibiotic therapy with infection recurrence

2019 NEJM Controlled trial quality: predicted high

85. A Randomized Trial of Prophylactic Antibiotics for Miscarriage Surgery. Full Text available with Trip Pro

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

2019 NEJM Controlled trial quality: predicted high

86. 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. Full Text available with Trip Pro

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

2019 BMJ

87. Duration of antibiotic treatment for common infections in English primary care: cross sectional analysis and comparison with guidelines. Full Text available with Trip Pro

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

2019 BMJ

88. Effectiveness and safety of electronically delivered prescribing feedback and decision support on antibiotic use for respiratory illness in primary care: REDUCE cluster randomised trial. Full Text available with Trip Pro

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 (...) 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

2019 BMJ Controlled trial quality: predicted high

89. Cough (acute): antimicrobial prescribing

1.1 Managing acute cough 5 1.2 Self-care 8 1.3 Choice of antibiotic 9 T erms used in the guideline 11 Acute cough 11 Acute bronchitis 11 Self-care treatments 11 Summary of the evidence 12 Self-care 12 Bronchodilators 22 Corticosteroids 23 Mucolytics 24 No antibiotic 25 Back-up antibiotics 29 Choice of antibiotic 33 Antibiotic course length 35 Other considerations 36 Medicines adherence 36 Resource implications 36 Cough (acute): antimicrobial prescribing (NG120) © NICE 2019. All rights reserved (...) . Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 36Ov Overview erview This guideline sets out an antimicrobial prescribing strategy for acute cough associated with an upper respiratory tract infection or acute bronchitis in adults, young people and children. It aims to limit antibiotic use and reduce antibiotic resistance. See a 2-page visual summary of the recommendations, including tables to support prescribing decisions. For treating coughs

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

90. There?s Pus About, So Are Antibiotics In or Out? Adding antibiotics for abscess management

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

2019 Tools for Practice

91. 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

92. Tailored Helicobacter pylori eradication based on prior intake of macrolide antibiotics allows the use of triple therapy with optimal results in an area with high clarithromycin resistance. Full Text available with Trip Pro

Tailored Helicobacter pylori eradication based on prior intake of macrolide antibiotics allows the use of triple therapy with optimal results in an area with high clarithromycin resistance. the previous intake of macrolide antibiotics is associated with a failure to eradicate Helicobacter pylori (H. pylori) with clarithromycin-containing regimens. However, the standard triple therapy achieves eradication rates of over 90% in patients without a previous use of macrolides in our health area

2019 Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva Controlled trial quality: uncertain

93. COPD exacerbation: no systematic use of antibiotics

COPD exacerbation: no systematic use of antibiotics Prescrire IN ENGLISH - Spotlight ''COPD exacerbation: no systematic use of antibiotics'', 1 January 2019 {1} {1} {1} | | > > > COPD exacerbation: no systematic use of antibiotics Spotlight Every month, the subjects in Prescrire’s Spotlight. 100 most recent :  |   |   |   |   |   |   |   |   |  Spotlight COPD exacerbation: no systematic use of antibiotics For episodes (...) of moderate aggravation in patients with chronic obstructive pulmonary disease (COPD), it is preferable to prescribe antibiotics as a first-line treatment only when the suspicion of bacterial infection is reinforced by an increase in sputum purulence. Patients with chronic obstructive pulmonary disease (COPD) are subject to exacerbations of their disease, i.e. episodes of prolonged aggravation. The known causes are mainly viral and bacterial infections. Some exacerbations justify hospitalisation: severe

2019 Prescrire

94. Bronchiectasis (non-cystic fibrosis), acute exacerbation: antimicrobial prescribing

Reassessment 14 Referral and seeking specialist advice 14 Choice of antibiotic for treating an acute exacerbation of bronchiectasis 15 Preventing acute exacerbations of bronchiectasis (non-cystic fibrosis) and choice of antibiotic 17 Bronchiectasis (non-cystic fibrosis), acute exacerbation: antimicrobial prescribing (NG117) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 19Ov Overview erview This guideline sets out (...) an antimicrobial prescribing strategy for managing and preventing acute exacerbations of bronchiectasis (non-cystic fibrosis). It aims to optimise antibiotic use and reduce antibiotic resistance. See a 3-page visual summary of the recommendations, including tables to support prescribing decisions. NICE has also produced a guideline on antimicrobial stewardship: systems and processes for effective antimicrobial medicine use. Who is it for? Health professionals People with bronchiectasis, their families

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

95. Adult and Pediatric Antibiotic Prophylaxis during Vascular and IR Procedures: A Society of Interventional Radiology Practice Parameter Update Endorsed by the Cardiovascular and Interventional Radological Society of Europe and the Canadian Association for

procedures, including the increasing prevalence of pediatric IR procedures, and the increasing repertoire of antibacterial agents. As was the case for the original guidelines (1), the availability of randomized controlled data regarding antibiotic prophylaxis is lacking in the IR literature. Much data are derived from retrospective reviews From the Department of Diagnostic Radiology (M.A.C.), Oakland University William Beaumont School of Medicine, Royal Oak, Michigan; Department of Radiology (A.S.T (...) to oropharyngeal ?ora, which can potentially seed the skin entry site. This procedure carries a peristomal infection rate of approximately 30% (156). Prophylactic antibiotic therapy is therefore recommended for all patients undergoing this procedure with antimicrobial agents targeting skin and oropharyngeal bacteria, eg, cefazolin followed by oral/enteric cephalexin (156). (New data reviewed, recommendations updated.) Liver Tumor Ablation In 2015, Bhatia et al (157) described a very low incidence of hepatic ab

2019 Society of Interventional Radiology

96. Primary care: Broad-spectrum antibiotics gave no clinical benefit and more adverse effects than narrow-spectrum antibiotics in treating acute respiratory tract infections in US children

no clinical benefit and more adverse effects than narrow-spectrum antibiotics in treating acute respiratory tract infections in US children Morten Lindbaek Statistics from Altmetric.com Commentary on : Gerber JS, Ross RK, Bryan M, et al . Association of Broad- vs Narrow-Spectrum Antibiotics With Treatment Failure, Adverse Events, and Quality of Life in Children With Acute Respiratory Tract Infections. JAMA. 2017 Dec 19;318:2325–2336. Context Antimicrobial prescribing is associated with higher levels (...) of resistance; a linear trend by nation has been presented. 1 Large variations in antimicrobial prescribing between countries have been demonstrated, the USA is in line with top EU countries like Greece and France, using three times more per inhabitant than the Nordic countries. Respiratory tract infections (RTIs) in primary care are frequently viral, and a large proportion of bacterial infections such as otitis media, sinusitis and sore throat have little benefit from antibiotic treatment. Another

2019 Evidence-Based Medicine

97. C-reactive protein point-of-care testing (CRP POCT) to guide antibiotic prescribing in primary care settings for acute respiratory tract infections. EUnetHTA-Report . HTA-Projektbericht 116.

C-reactive protein point-of-care testing (CRP POCT) to guide antibiotic prescribing in primary care settings for acute respiratory tract infections. EUnetHTA-Report . HTA-Projektbericht 116. C-reactive protein point-of-care testing (CRP POCT) to guide antibiotic prescribing in primary care settings for acute respiratory tract infections. EUnetHTA-Report - Repository of AIHTA GmbH English | Browse - - - C-reactive protein point-of-care testing (CRP POCT) to guide antibiotic prescribing (...) in primary care settings for acute respiratory tract infections. EUnetHTA-Report Harrington, P. and Lucey, D. and O’Brien, K. and Jordan, K. and Moran, P. and Marshall, L. and Wilbacher, I. and Gloeckner, L. (2019): C-reactive protein point-of-care testing (CRP POCT) to guide antibiotic prescribing in primary care settings for acute respiratory tract infections. EUnetHTA-Report . HTA-Projektbericht 116. Preview - Sie müssen einen PDF-Viewer auf Ihrem PC installiert haben wie z. B. , oder 3MB Abstract

2019 Austrian Institute of Health Technology Assessment

98. Diarrhoea - antibiotic associated: Scenario: Diarrhoea - antibiotic associated

in a NICE evidence summary on the risk of C. difficile with broad-spectrum antibiotics [ ], Public Health England diagnostic guidance [ ], and North American practice parameters [ ]. The most frequently implicated antibiotics include broad-spectrum penicillins, cephalosporins, clindamycin, and flouroquinolones, but most antibiotics have been associated with C. difficile infection [ ; ; ; ]. The risk of C. difficile infection is increased with greater number of antimicrobials used, higher doses (...) leading to toxic megacolon and intestinal perforation and necrosis [ ; ; ]. Antibiotics for treating mild to moderate Clostridium difficile infection The recommendations regarding the choice of antibiotic to treat C. difficile infection is based on guidance published by Public Health England: Updated guidance on the management and treatment of Clostridium difficile infection [ ], Managing suspected infectious diarrhoea [ ] and Summary of antimicrobial prescribing guidance - managing common infections

2019 NICE Clinical Knowledge Summaries

99. Diarrhoea - antibiotic associated: Metronidazole

Diarrhoea - antibiotic associated: Metronidazole Metronidazole | Prescribing information | Diarrhoea - antibiotic associated | CKS | NICE Search CKS… Menu Metronidazole Diarrhoea - antibiotic associated: Metronidazole Last revised in March 2019 Metronidazole What are the cautions and contraindications with metronidazole? Do not prescribe metronidazole in people with: Known metronidazole or nitroimidazole hypersensitivity. Prescribe metronidazole with caution in people with: Cockayne syndrome

2019 NICE Clinical Knowledge Summaries

100. Acne vulgaris: Topical antibiotics

Acne vulgaris: Topical antibiotics Topical antibiotics | Prescribing information | Acne vulgaris | CKS | NICE Search CKS… Menu Topical antibiotics Acne vulgaris: Topical antibiotics Last revised in December 2019 Topical antibiotics Topical antibiotics Prescribing issues Topical antibiotics licenced in the UK for treatment of acne vulgaris include clindamycin and erythromycin. Application is usually once or twice a day and varies between agents — for information on specific products see (...) the (BNF) and the . Topical monotherapy with antibiotics is not recommended because of the risk of antibiotic resistance. Topical antibiotics should be prescribed in combination with benzoyl peroxide. Cautions and contraindications Hypersensitivity to the active ingredient or any of the excipients. History of inflammatory bowel disease or a history of antibiotic-associated colitis. If diarrhoea occurs, the product should be discontinued immediately. Caution is advised when prescribing to people

2019 NICE Clinical Knowledge Summaries