Latest & greatest articles for antibiotics

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This page lists the very latest high quality evidence on antibiotics and also the most popular articles. Popularity measured by the number of times the articles have been clicked on by fellow users in the last twelve months.

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Antibiotics

Antibiotics also referred to as antibacterial are a type of medicine that prevents the growth of bacteria. As such they are used to treat infections caused by bacteria. They kill or prevents bacteria from spreading.

Antibiotics are vital in modern day medicine; they are among the most frequently prescribed drug. There are over a 100 types of antibiotics, the main types and most commonly prescribed are penicillin, cephalosporin, macrolides, fluoroquinolone and tetracycline. They tend to be classified by mechanism of action. So, those that target the bacterial cell wall (penicillins and cephalosporins) or the cell membrane (polymyxins), or interfere with essential bacterial enzymes (rifamycins, lipiarmycins, quinolones, and sulfonamides) have bactericidal activities. Antibiotics such as macrolides, lincosamides and tetracyclines inhibit protein synthesis.

Antibiotics can all be defined by their specificity. “Narrow-spectrum” antibiotics target specific types of bacteria, for instance gram-negative (-ve) or gram-positive (+ve), whereas broad-spectrum antibiotics affect a wide range of bacteria.

Antibiotics are increasingly suffering from antibiotic resistance caused by bacterial mutations meaning the bacteria evolves to not be sensitive to the specific antibiotics being used.

Clinical trials are important to the development and understanding of antibiotics and their side effects. Although they are deemed safe, over use of the drug can kill good bacteria and lead to antibiotic resistance. This halts the ability of bacteria and microorganisms to resist the effects of the antibiotic. Clinical trials and research allow scientists and medical professionals to study the effects and develop new antibiotics.

Trip has extensive coverage of the evidence base on antibiotics allowing users to easily find trusted answers. Coverage include guidelines, systematic reviews, controlled trials and evidence-based synopses.

Top results for antibiotics

1. Otitis media (acute): antimicrobial prescribing

is it for? 4 Recommendations 5 1.1 Managing acute otitis media 5 1.2 Self-care 7 1.3 Choice of antibiotic 8 Summary of the evidence 10 Self-care 10 Oral corticosteroids 11 No antibiotic 12 Back-up antibiotics 14 Choice of antibiotic 16 Antibiotic course length 18 Antibiotic dose frequency 19 Other considerations 21 Medicines adherence 21 Resource implications 21 Otitis media (acute): antimicrobial prescribing (NG91) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk (...) /terms-and- conditions#notice-of-rights). Page 3 of 21Ov Overview erview This guideline sets out an antimicrobial prescribing strategy for acute otitis media (ear infection). It aims to limit antibiotic use and reduce antimicrobial resistance. Acute otitis media can be caused by viruses or bacteria. It lasts for about a week, and most children get better in 3 days without antibiotics. Serious complications are rare. See a 2-page visual summary of the recommendations, including tables to support

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

2. Pneumonia (community-acquired): antimicrobial prescribing

37 Resource implications 37 Pneumonia (community-acquired): antimicrobial prescribing (NG138) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 37Ov Overview erview This guideline sets out an antimicrobial prescribing strategy for adults, young people, children and babies aged 72 hours and over with a confirmed diagnosis of community-acquired pneumonia. It aims to optimise antibiotic use and reduce antibiotic (...) disease or immunosuppression local antimicrobial resistance and surveillance data (such as flu and Mycoplasma pneumoniae infection rates) recent antibiotic use recent microbiological results, including colonisation with multidrug-resistant bacteria. 1.1.2 Start antibiotic treatment as soon as possible after establishing a diagnosis of community-acquired pneumonia, and certainly within 4 hours (within 1 hour if the person has suspected sepsis and meets any of the high risk criteria for this – see

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

3. Chronic wounds: advanced wound dressings and antimicrobial dressings

Chronic wounds: advanced wound dressings and antimicrobial dressings Chronic wounds: advanced wound dressings and Chronic wounds: advanced wound dressings and antimicrobial dressings antimicrobial dressings Evidence summary Published: 30 March 2016 nice.org.uk/guidance/esmpb2 pathways K Ke ey points from the e y points from the evidence vidence The content of this evidence summary was up-to-date in March 2016. See summaries of product characteristics (SPCs), British national formulary (BNF (...) ) or the MHRA or NICE websites for up-to-date information. Overall summary This evidence summary discusses the best available evidence for advanced wound dressings and antimicrobial dressings for managing common chronic wounds (diabetic foot ulcers, pressure ulcers, venous leg ulcers and infected wounds). It includes evidence and recommendations from national guidance (if available) and the most up-to-date systematic reviews and meta-analyses (search date July 2015). Dressings should provide the optimal

2016 National Institute for Health and Clinical Excellence - Advice

4. Urinary tract infection (recurrent): antimicrobial prescribing

a catheter. It aims to optimise antibiotic use and reduce antibiotic resistance. See a 2-page visual summary of the recommendations, including a table 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 recurrent urinary tract infection, their families and carers Urinary tract infection (recurrent): antimicrobial prescribing (NG112) © NICE 2019 (...) and over people with recurrent upper UTI people with recurrent lower UTI when the underlying cause is unknown pregnant women children and young people under 16 years in line with the NICE guideline on urinary tract infection in under 16s people with suspected cancer in line with the NICE guideline on suspected cancer: recognition and referral. See the evidence and committee discussion on antibiotic prophylaxis. Urinary tract infection (recurrent): antimicrobial prescribing (NG112) © NICE 2019. All

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

5. Urinary tract infection (lower): antimicrobial prescribing

of 35Contents Contents Overview 4 Who is it for? 4 Recommendations 5 1.1 Managing lower urinary tract infection 5 1.2 Managing asymptomatic bacteriuria 8 1.3 Self-care 9 1.4 Choice of antibiotic 9 Summary of the evidence 15 Self-care 15 Antibiotics 16 Choice of antibiotic 23 Antibiotic course length 29 Other considerations 34 Medicines adherence 34 Resource implications 34 Update information 35 Urinary tract infection (lower): antimicrobial prescribing (NG109) © NICE 2019. All rights reserved. Subject (...) to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 35This guideline should be read in conjunction with CG54, NG111 and NG112. Ov Overview erview This guideline sets out an antimicrobial prescribing strategy for lower urinary tract infection (also called cystitis) in children, young people and adults who do not have a catheter. It aims to optimise antibiotic use and reduce antibiotic resistance. See a 3-page visual summary of the recommendations, including

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

6. The Collaborative Assessment, OTCA12, on “C-reactive protein point-of-care testing (CRP POCT) to guide antibiotic prescribing in primary care settings for acute respiratory tract infections (RTIs)

-reactive protein point-of-care testing to guide antibiotic prescribing for acute respiratory tract infections in primary care EUnetHTA Joint Action 3 WP4 3 Consultation of the draft Rapid Assessment External experts [V.1.3] Elizabeth Beech, National Project Lead – Healthcare Acquired Infection and Antimicrobial Resistance, NHS Improvement, England Dr Nuala O’Connor, Irish College of General Practitioners (ICGP) GP Lead HSE Clinical Programme HCAI-AMR Professor Martin Cormican, National Clinical Lead (...) ) RECOMMENDATIONS IN EUROPEAN COUNTRIES FOR CRP POCT 248 Figures FIGURE 1: ANATOMY OF THE RESPIRATORY TRACT 67 FIGURE 2: ANTIMICROBIAL RESISTANCE (COMBINED NON-SUSCEPTIBILITY FOR PENICILLINS AND MACROLIDES) VERSUS STREPTOCOCCUS PNEUMONIAE IN EU/EEA COUNTRIES, 2017 68 FIGURE 3: CONSUMPTION OF ANTIBIOTICS FOR SYSTEMIC USE IN THE COMMUNITY, EU/EEA COUNTRIES, 2016 (EXPRESSED AS DDD PER 1 000 INHABITANTS PER DAY) 69 FIGURE 4: FLOW CHART SYSTEMATIC REVIEW 1 (EFFECTIVENESS AND SAFETY) 83 C-reactive protein point

2019 EUnetHTA

7. Antibacterial-coated sutures versus non-antibacterial-coated sutures for the prevention of abdominal, superficial and deep, surgical site infection (SSI)

low risk of bias RCTs 83 Table 19: The length of hospital stay in triclosan-coated vs non-antibacterial coated sutures patient groups 85 Table 20: The proportion of patients requiring secondary surgery for wound-related complications of surgery 86 Table 21: The incidence of complete abdominal wound dehiscence within 30 days of surgery and incisional hernia during the period of study follow-up 87 Table 22: Causative microorganism of SSI and the use of systemic antibiotic therapy within 30 days (...) Controlled Trial REA Relative Effectiveness Assessment RoB Risk of Bias RR Relative risk SAE Serious Adverse Event SAF Safety domain Antibacterial-coated sutures for the prevention of abdominal SSI Version 1.4, March 2017 EUnetHTA Joint Action 3 WP4 10 SAP Surgical antibiotic prophylaxis SDGC Study Center of the German Surgical Society SHEA The Society for Healthcare Epidemiology of America SHEA/IDSA Society for Healthcare Epidemiology of America/Infectious Diseases Society of America SI Superficial

2017 EUnetHTA

8. Is the use of chlorhexidine contributing to increased resistance to chlorhexidine and/or antibiotics?

’ defined by using the clinical breakpoints for resistance as specified by the European Committee on Antimicrobial Susceptibility testing (EUCAST) or the Clinical and Laboratory Standards Institute (CSLI). 2. Increase in the incidence (rate) of antibiotic-resistant strains of bacteria established through the use of chlorhexidine identifying dosage form, exposure and specific population and / or setting. Antibiotic-resistant strain of bacteria through the use of chlorhexidine to be recorded. 3. Increases (...) to chlorhexidine in a specific population and / or setting. To address the question ‘Does exposure (different dosages, duration of use, and stratification of exposure) to any form of chlorhexidine increases the incidence and/or prevalence of antibiotic- resistant strains of bacteria in any person within different healthcare settings? ’ the outcomes included: ? ‘Resistance against antibiotics’ defined by using the clinical breakpoints for resistance as specified by the European Committee on Antimicrobial

2018 National Health and Medical Research Council

9. Sore throat (acute): antimicrobial prescribing

Recommendations 5 1.1 Managing acute sore throat 5 1.2 Self-care 7 1.3 Choice of antibiotic 8 Summary of the evidence 10 Self-care 10 Corticosteroids 12 No antibiotic 12 Back-up antibiotics 14 Identifying people more likely to benefit from antibiotics 14 Antibiotic choice 18 Antibiotic course length 20 Other considerations 22 Medicines adherence 22 Resource implications 22 T erms used in the guideline 23 FeverPAIN criteria 23 Centor criteria 23 Sore throat (acute): antimicrobial prescribing (NG84) © NICE 2019 (...) . All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 24Ov Overview erview This guideline sets out an antimicrobial prescribing strategy for acute sore throat. It aims to limit antibiotic use and reduce antimicrobial resistance. Acute sore throat is often caused by a virus, lasts for about a week, and most people get better without antibiotics. Withholding antibiotics rarely leads to complications. See a 2-page visual summary

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

10. Antibiotics and antiseptics for wounds: evidence and ignorance

randomized controlled trials (RCTs) on the effects of systemic and topical antibiotics, and topical antiseptics, on pressure ulcer healing in any clinical setting. They found 12 relevant trials with 576 participants, all assessing topical agents: povidone iodine, cadexomer iodine, gentian violet, lysozyme, silver dressings, honey, pine resin, polyhexanide, silver sulfadiazine, and nitrofurazone with ethoxy-diaminoacridine. They were compared with alternative antimicrobials or other ointments (...) (SWHSI) reaches similar conclusions to the pressure ulcer review. There is no robust evidence on the relative effectiveness of any antiseptic, antibiotic or antimicrobial for SWHSI. Barts nurses (date uncertain). Photo from the private collection of Peter Maleczek, with permission The review includes 8 RCTs with 886 participants, evaluating a range of comparisons and, once again, studies tended to be small and poorly reported. My eyes widened when I read that one study, from as recently as 2005

2016 Evidently Cochrane

11. HTA of C-reactive protein point-of-care testing to guide antibiotic prescribing

a range of health services, in conjunction with the Department of Health and the HSE. Health Technology Assessment (HTA) of CRP POCT Health Information and Quality Authority iv Foreword Antimicrobial resistance occurs when bacteria adapt in response to the use of medicines. When bacteria become antibiotic resistant, infections become more difficult to manage and treat. Antimicrobial resistance is a significant threat to public health, and widely acknowledged to be associated with the excessive (...) , but not for those with acute bronchitis. ? Overprescribing of antibiotics for RTIs in primary care is common in most industrialised countries, with high levels of inappropriate prescribing documented. Antibiotic treatment of RTIs can expose patients to an increased risk of an adverse event, with one out of five patients experiencing mostly minor and self-limiting adverse events. Antimicrobial resistance (AMR) is a growing and significant threat to public health, and it is widely recognised that antibiotic

2019 Health Information and Quality Authority

12. 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

13. Pneumonia (hospital-acquired): antimicrobial prescribing

of 23Contents Contents Overview 4 Who is it for? 4 Recommendations 5 1.1 Managing hospital-acquired pneumonia 5 1.2 Choice of antibiotic 6 T erms used in the guideline 13 Hospital-acquired pneumonia 13 Summary of the evidence 14 Antibiotic prescribing strategies 14 Choice of antibiotics 15 Antibiotic course length, dosage and route of administration 22 Other considerations 23 Medicines adherence 23 Resource implications 23 Pneumonia (hospital-acquired): antimicrobial prescribing (NG139) © NICE 2019. All (...) rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 23Ov Overview erview This guideline sets out an antimicrobial prescribing strategy for adults, young people, children and babies aged 72 hours and over with a confirmed diagnosis of hospital-acquired pneumonia. It does not cover ventilator-associated pneumonia. It aims to optimise antibiotic use and reduce antibiotic resistance. See a 3-page visual summary of the recommendations

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

14. Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery Full Text available with Trip Pro

be expected to be quite small with single-dose antibiotic prophylaxis. Although the use of fluoroquinolones may be necessary for surgical antibiotic prophylaxis in some children, they are not drugs of first choice in the pediatric population due to an increased incidence of adverse events as compared with controls in some clinical trials. k Ceftriaxone use should be limited to patients requiring antimicrobial treatment for acute cholecystitis or acute biliary tract infections which may not be determined (...) with negative pretransplantation cultures should receive antimicrobial prophylaxis as appropriate for other types of cardiothoracic surgeries. Patients undergoing lung transplantation for cystic fibrosis should receive 7–14 days of treatment with antimicrobials selected according to pretransplantation culture and susceptibility results. This treatment may include additional antibacterial or antifungal agents. t The prophylactic regimen may need to be modified to provide coverage against any potential

2013 Infectious Diseases Society of America

15. C-reactive protein point-of-care testing for safely reducing antibiotics for acute exacerbations of chronic obstructive pulmonary disease: the PACE RCT Full Text available with Trip Pro

C-reactive protein point-of-care testing for safely reducing antibiotics for acute exacerbations of chronic obstructive pulmonary disease: the PACE RCT C-reactive protein point-of-care testing for safely reducing antibiotics for acute exacerbations of chronic obstructive pulmonary disease: the PACE RCT Journals Library An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could not be found. Please choose (...) a page from the navigation or try a website search above to find the information you need. >> >> >> >> Issue {{metadata .Issue }} Toolkit 1)"> 0)"> 1)"> {{metadata.Title}} {{metadata.Headline}} Point-of-care testing resulted in a 20% absolute reduction in patient-reported antibiotic consumption over 4 weeks, without impairing chronic obstructive pulmonary disease health status. {{author}} {{($index , , , , , , , , , , , , , , , , , , , , & . Nick A Francis 1, * , David Gillespie 2 , Patrick White 3

2020 NIHR HTA programme

16. Cost-analysis of prophylactic antibiotics in spontaneous bacterial peritonitis

Cost-analysis of prophylactic antibiotics in spontaneous bacterial peritonitis Cost-analysis of prophylactic antibiotics in spontaneous bacterial peritonitis Cost-analysis of prophylactic antibiotics in spontaneous bacterial peritonitis Inadomi J, Sonnenberg A Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical (...) assessment on the reliability of the study and the conclusions drawn. Health technology Prophylactic antibiotics (norfloxacin 400 mg daily and trimethroprim-sulfamethoxazole 160mg/800mg 5 days per week). Type of intervention Secondary prevention. Economic study type Cost-effectiveness analysis. Study population Hypothetical cohort of 100 patients with ascites and cirrhosis. Three cases were separately investigated, with patients having: (1) a previous history of SBP; (2) no previous history of SBP

1997 NHS Economic Evaluation Database.

17. Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals ? protocol version 5.3

Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals ? protocol version 5.3 www.ecdc.europa.eu Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals Protocol version 5.3 TECHNICAL DOCUMENT ECDC TECHNICAL DOCUMENT Point prevalence survey of healthcare- associated infections and antimicrobial use in European acute care hospitals Protocol version 5.3, ECDC PPS 2016–2017 ii (...) Suggested citation: European Centre for Disease Prevention and Control. Point prevalence survey of healthcare- associated infections and antimicrobial use in European acute care hospitals – protocol version 5.3. Stockholm: ECDC; 2016. Stockholm, October 2016 ISBN 978-92-9193-993-0 doi 10.2900/374985 TQ-04-16-903-EN-N © European Centre for Disease Prevention and Control, 2016 Reproduction is authorised, provided the source is acknowledged. TECHNICAL DOCUMENT PPS of HAIs and antimicrobial use in European

2016 European Centre for Disease Prevention and Control - Technical Guidance

18. Comparative efficacy of long-term antibiotic treatments in the primary prophylaxis of spontaneous bacterial peritonitis. (Abstract)

Comparative efficacy of long-term antibiotic treatments in the primary prophylaxis of spontaneous bacterial peritonitis. Several antibiotic treatments aiming to prevent spontaneous bacterial peritonitis (SBP) in cirrhotic patients with low-protein content in ascitic fluid have been tested; however, there are limited data on the comparative efficacy of these regimens. We assessed their comparative efficacy through a network meta-analysis and using GRADE criteria to appraise quality (...) of evidence.Through literature review through October 2018, we identified 10 randomized controlled trials comparing antibiotic treatments (norfloxacin, ciprofloxacin, trimethoprim/sulfamethoxazole and rifaximin) with each other or placebo. Primary outcome was SBP occurrence, with mortality rate and rate of other infections as secondary outcomes.In comparison with placebo, moderate quality evidence supports the use of norfloxacin and ciprofloxacin in primary prophylaxis of SBP (risk ratio 0.23; 95% CI, 0.09-0.56

2019 Liver International

19. Cellulitis and erysipelas: antimicrobial prescribing

. 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. For managing other skin conditions, see our web page on skin conditions. NICE has also produced a guideline on antimicrobial stewardship: systems and processes for effective antimicrobial medicine use. Who is it for? Healthcare professionals People with cellulitis and erysipelas, their families and carers Cellulitis and erysipelas (...) Staphylococcus aureus (MRSA) status if known. 1.1.5 Give oral antibiotics first line if the person can take oral medicines, and the severity of their condition does not require intravenous antibiotics. Cellulitis and erysipelas: antimicrobial prescribing (NG141) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 5 of 361.1.6 If intravenous antibiotics are given, review by 48 hours and consider switching to oral antibiotics

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

20. Antimicrobial prescribing: ceftolozane with tazobactam for treating hospital-acquired pneumonia, including ventilator-associated pneumonia

for Antimicrobial Utilisation and Resistance (ESPAUR) Report 2018 to 2019 states that monitoring the use of new antibiotics and detecting emerging resistance to these medicines is a crucial component of antimicrobial usage surveillance to inform antimicrobial stewardship activities and preserve treatment effectiveness. Although susceptibility testing for ceftolozane with tazobactam is currently uncommon and selective (following resistance to first- and second-line antibiotics), resistance has nonetheless been (...) ) is Antimicrobial prescribing: ceftolozane with tazobactam for treating hospital-acquired pneumonia, including ventilator-associated pneumonia (ES22) © NICE 2020. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 5 of 6£402.18 (BNF, November 2019). The acquisition costs (excluding VAT) of many other IV antibiotics that are used for HAP and VAP (caused or suspected to be caused by Gram-negative pathogens) are lower than that of ceftolozane

2020 National Institute for Health and Clinical Excellence - Advice