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Latest & greatest articles for macrolides
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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
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 (...) . The aim of this study was to evaluate the efficacy of an H. pylori eradication strategy based on the intake of macrolides by the patient during the previous years.one hundred and sixty-nine patients with H. pylori infection were prospectively included in the study. The electronic medical record of each patient was reviewed at the time of inclusion. Depending on their previous intake of macrolides, patients were assigned to one of two eradication regimens: group A) patients without a previous intake
Macrolide antibiotics for bronchiectasis. Bronchiectasis is a chronic respiratory disease characterised by abnormal and irreversible dilatation and distortion of the smaller airways. Bacterial colonisation of the damaged airways leads to chronic cough and sputum production, often with breathlessness and further structural damage to the airways. Long-term macrolide antibiotic therapy may suppress bacterial infection and reduce inflammation, leading to fewer exacerbations, fewer symptoms (...) , improved lung function, and improved quality of life. Further evidence is required on the efficacy of macrolides in terms of specific bacterial eradication and the extent of antibiotic resistance.To determine the impact of macrolide antibiotics in the treatment of adults and children with bronchiectasis.We identified trials from the Cochrane Airways Trials Register, which contains studies identified through multiple electronic searches and handsearches of other sources. We also searched trial
Macrolides for treatment of Haemophilus ducreyi infection in sexually active adults. Chancroid is a genital ulcerative disease caused by Haemophilus ducreyi. This microorganism is endemic in Africa, where it can cause up to 10% of genital ulcers. Macrolides may be an effective alternative to treat chancroid and, based on their oral administration and duration of therapy, could be considered as first line therapy.To assess the effectiveness and safety of macrolides for treatment of H ducreyi (...) infection in sexually active adults.We searched the Cochrane STI Group Specialized Register, CENTRAL, MEDLINE, Embase, LILACS, WHO ICTRP, ClinicalTrials.gov and Web of Science to 30 October 2017. We also handsearched conference proceedings and reference lists of retrieved studies.Randomized controlled trials (RCTs) comparing macrolides in different regimens or with other therapeutic alternatives for chancroid.Two review authors independently assessed trials for inclusion, extracted data and assessed
Evaluation of severity score-guided approaches to macrolide use in community-acquired pneumonia International guidelines including those in the UK, Japan, Australia and South Africa recommend the avoidance of macrolides in patients with low-severity community-acquired pneumonia (CAP). We hypothesised that severity scores are poor predictors of atypical pneumonia and response to macrolide therapy, and thus, inadequate tools for guiding antibiotic prescriptions.Secondary analysis of four (...) independent prospective CAP datasets was conducted. The predictive values of the CURB-65 and pneumonia severity index (PSI) for clinically important groups of causative pathogens were evaluated. The effect of macrolide use according to risk class was assessed by multivariable analysis. Patients (3297) were evaluated, and the predictive values of CURB-65 and PSI for atypical pathogens were poor (AUC values of 0.37 and 0.42, respectively). No significant differences were noted among the effects of macrolide
Macrolide antibiotics and the risk of ventricular arrhythmia in older adults Many respiratory tract infections are treated with macrolide antibiotics. Regulatory agencies warn that these antibiotics increase the risk of ventricular arrhythmia. We examined the 30-day risk of ventricular arrhythmia and all-cause mortality associated with macrolide antibiotics relative to nonmacrolide antibiotics.We conducted a population-based retrospective cohort study involving older adults (age > 65 yr (...) ) with a new prescription for an oral macrolide antibiotic (azithromycin, clarithromycin or erythromycin) in Ontario from 2002 to 2013. Our primary outcome was a hospital encounter with ventricular arrhythmia within 30 days after a new prescription. Our secondary outcome was 30-day all-cause mortality. We matched patients 1:1 using propensity scores to patients prescribed nonmacrolide antibiotics (amoxicillin, cefuroxime or levofloxacin). We used conditional logistic regression to measure the association
Macrolides for chronic asthma. Asthma is a chronic disease in which inflammation of the airways causes symptomatic coughing, wheezing, and difficult breathing. The inflammation may have different underlying causes, including a reaction to infection in the lungs. Macrolides are antibiotics with antimicrobial and antiinflammatory activities that have been used long-term to control asthma symptoms.To assess the effects of macrolides for managing chronic asthma.We searched the Cochrane Airways (...) Group Specialised Register up to April 2015. We also manually searched bibliographies of previously published reviews and conference proceedings and contacted study authors. We included records published in any language in the search.Randomised controlled clinical trials involving both children and adults with chronic asthma treated with macrolides versus placebo for more than four weeks .Two reviewers independently examined all records identified in the searches then reviewed the full text of all
Macrolides for diffuse panbronchiolitis. Diffuse panbronchiolitis (DPB) is a chronic airways disease predominantly affecting East Asians. Macrolides, a class of antibiotics, have been used as the main treatment for DPB, based on evidence from retrospective and non-randomised studies.To assess the efficacy and safety of macrolides for DPB.We searched CENTRAL (2014, Issue 6), MEDLINE (1966 to July week 1, 2014), EMBASE (1974 to July 2014), Chinese Biomedical Literature Database (CBM) (1978 (...) to July 2014), China National Knowledge Infrastructure (CNKI) (1974 to July 2014), KoreaMed (1997 to July 2014) and Database of Japana Centra Revuo Medicina (1983 to July 2014).Randomised controlled trials (RCTs) or quasi-RCTs assessing the effect of macrolides for DPB.Two review authors independently assessed study quality and subsequent risk of bias according to The Cochrane Collaboration's tool for assessing risk of bias. The primary outcomes were five-year survival rate, lung function and clinical
Macrolides USE OF MACROLIDES IN PREGNANCY 0344 892 0909 USE OF MACROLIDES IN PREGNANCY (Date of issue: June 2017 , Version: 2.1 ) This is a UKTIS monograph for use by health care professionals. For case-specific advice please contact UKTIS on 0344 892 0909. To report an exposure please download and complete a . Please encourage all women to complete an . A corresponding patient information leaflet on is available at . Summary The macrolide antibiotics include azithromycin, clarithromycin (...) , erythromycin, spiramycin and telithromycin. Macrolides have an antibacterial spectrum similar to that of penicillin and are thus considered an alternative in penicillin-allergic patients. Indications include sinusitis, otitis media, pharyngitis, tonsillitis, bronchitis, skin and soft tissue infection. Azithromycin is also used in the treatment of chlamydia, and clarithromycin in the eradication of Helicobacter pylori . The considerable data for macrolides as a class, and for erythromycin specifically, do
Macrolide therapy for chronic rhinosinusitis: a meta-analysis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Statin toxicity from macrolide antibiotic coprescription: a population-based cohort study. Clarithromycin and erythromycin, but not azithromycin, inhibit cytochrome P450 isoenzyme 3A4 (CYP3A4), and inhibition increases blood concentrations of statins that are metabolized by CYP3A4.To measure the frequency of statin toxicity after coprescription of a statin with clarithromycin or erythromycin.Population-based cohort study.Ontario, Canada, from 2003 to 2010.Continuous statin users older than 65
Macrolides for diffuse panbronchiolitis. Diffuse panbronchiolitis (DPB) is a chronic airways disease predominantly affecting East Asians. Macrolides, a class of antibiotics, have been used as the main treatment for DPB, based on evidence from retrospective and non-randomised studies.To assess the efficacy and safety of macrolides for DPB.We searched CENTRAL 2012, Issue 7, MEDLINE (1966 to July week 2, 2012), EMBASE (1974 to July 2012), Chinese Biomedical Literature Database (CBM) (1978 to July (...) 2012), China National Knowledge Infrastructure (CNKI) (1974 to July 2012), KoreaMed (1997 to July 2012) and Database of Japana Centra Revuo Medicina (1983 to July 2012).Randomised controlled trials (RCTs) or quasi-RCTs assessing the effect of macrolides for DPB.Two review authors independently assessed study quality and subsequent risk of bias according to the Cochrane Collaboration's tool for assessing risk of bias. The primary outcomes were five-year survival rate, lung function and clinical
Macrolide antibiotics for cystic fibrosis. Macrolide antibiotics may have a modifying role in diseases which involve airway infection and inflammation, like cystic fibrosis.To test the hypotheses that, in people with cystic fibrosis, macrolide antibiotics: 1. improve clinical status compared to placebo or another antibiotic; 2. do not have unacceptable adverse effects. If benefit was demonstrated, we aimed to assess the optimal type, dose and duration of macrolide therapy.We searched (...) the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register comprising references identified from comprehensive electronic database searches, handsearching relevant journals and abstract books of conference proceedings.We contacted investigators known to work in the field, previous authors and pharmaceutical companies manufacturing macrolide antibiotics for unpublished or follow-up data (May 2010).Latest search of the Group's Cystic Fibrosis Trials Register: 09 February 2011.Randomised
The risk of hypotension following co-prescription of macrolide antibiotics and calcium-channel blockers The macrolide antibiotics clarithromycin and erythromycin may potentiate calcium-channel blockers by inhibiting cytochrome P450 isoenzyme 3A4. However, this potential drug interaction is widely underappreciated and its clinical consequences have not been well characterized. We explored the risk of hypotension or shock requiring hospital admission following the simultaneous use of calcium (...) -channel blockers and macrolide antibiotics.We conducted a population-based, nested, case-crossover study involving people aged 66 years and older who had been prescribed a calcium-channel blocker between Apr. 1, 1994, and Mar. 31, 2009. Of these patients, we included those who had been admitted to hospital for the treatment of hypotension or shock. For each antibiotic, we estimated the risk of hypotension or shock associated with the use of a calcium blocker using a pair-matched analytic approach
Macrolides for diffuse panbronchiolitis. Diffuse panbronchiolitis (DPB) is a chronic airways disease predominantly affecting East Asians. Macrolides, a class of antibiotics, have been used as the main treatment for DPB, based on evidence from retrospective and non-randomised studies.To assess the efficacy and safety of macrolides for DPB.We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, issue 1), which contains the Cochrane Acute Respiratory (...) Infections Group's Specialised Register, MEDLINE (1966 to April 2010), EMBASE (1974 to April 2010), Chinese Biomedical Literature Database (CBM) (1978 to April 2010), China National Knowledge Infrastructure (CNKI) (1974 to April 2010), KoreaMed (1997 to April 2010) and Database of Japana Centra Revuo Medicina (1983 to April 2010).Randomised controlled trials (RCTs) or quasi-RCTs assessing the effect of macrolides for DPB.Two review authors independently assessed study quality and subsequent risk of bias
Increased clinical failures when treating acute otitis media with macrolides: a meta-analysis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Does the Overuse of Macrolides Lead to Antibiotic Resistance? Does the Overuse of Macrolides Lead to Antibiotic Resistance? – Clinical Correlations Search Does the Overuse of Macrolides Lead to Antibiotic Resistance? March 12, 2007 3 min read Commentary By: Danise Schiliro, PGY-3 Although intuitively we always worry about creating drug resistance when using antibiotics, there is a surprising lack of well done studies that show a clear causal effect of antibiotic use on the development (...) of subsequent drug resistance. A recent study in Lancet may however lead us to re-evaluate our use of macrolides in everyday practice. Azithromycin and clarithromycin are two of the most commonly used macrolides for treating respiratory infections. Azithromycin has a long half-life, making it convenient for once daily dosing, while clarithromycin has a shorter half-life and needs to be given twice daily for 7 days. Theoretically, shorter drug exposure decreases the chance of developing resistance
Effect of azithromycin and clarithromycin therapy on pharyngeal carriage of macrolide-resistant streptococci in healthy volunteers: a randomised, double-blind, placebo-controlled study. Resistance to antibiotics is a major public-health problem, and studies that link antibiotic use and resistance have shown an association but not a causal effect. We used the macrolides azithromycin and clarithromycin to investigate the direct effect of antibiotic exposure on resistance in the oral streptococcal (...) flora of healthy volunteers.Volunteers were treated with azithromycin (n=74), clarithromycin (74), or placebo (76) in a randomised, double-blind trial. Pharyngeal swabs were obtained before and after administration of study treatment through 180 days. The proportion of streptococci that were macrolide resistant was assessed and the molecular basis of any change in resistance investigated. Analyses were done on an intent-to-treat basis. This study is registered with ClinicalTrials.gov, number
2007LancetControlled trial quality: predicted high