Latest & greatest articles for antibiotics

The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on antibiotics or other clinical topics then use Trip today.

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.

What is Trip?

Trip is a clinical search engine designed to allow users to quickly and easily find and use high-quality research evidence to support their practice and/or care.

Trip has been online since 1997 and in that time has developed into the internet’s premier source of evidence-based content. Our motto is ‘Find evidence fast’ and this is something we aim to deliver for every single search.

As well as research evidence we also allow clinicians to search across other content types including images, videos, patient information leaflets, educational courses and news.

For further information on Trip click on any of the questions/sections on the left-hand side of this page. But if you still have questions please contact us via jon.brassey@tripdatabase.com

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. 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

82. 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

83. 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

84. 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

85. 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

86. Diarrhoea - antibiotic associated

-related behaviours in the general population . Review and, if appropriate, optimise current prescribing practice and use implementation techniques to ensure prescribing is in line with NICE antimicrobial prescribing guidelines or Public Health England (PHE) guidance on managing common infections in primary care, the Department of Health's guidance Start smart − then focus , local trust antimicrobial guidelines and the Antimicrobial Stewardship in Primary Care collaboration TARGET antibiotics toolkit (...) mechanisms [ ; ; ; ; ]: Disruption of the bowel microbiota and mucosal integrity. As a direct effect of the antibiotic (independent of its antimicrobial effect) — for example erythromycin can increase the rate of gastric emptying by acting as a motilin receptor agonist. Overgrowth of toxin-producing strains of Clostridium difficile (a Gram-positive, spore-forming, anaerobic bacillus) due to disruption of harmless bacteria in the gut. Overgrowth of C. difficile alone does not cause diarrhoea. C. difficile

2019 NICE Clinical Knowledge Summaries

87. 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

88. Antibiotic allergy. Full Text available with Trip Pro

Antibiotic allergy. Antibiotics are the commonest cause of life-threatening immune-mediated drug reactions that are considered off-target, including anaphylaxis, and organ-specific and severe cutaneous adverse reactions. However, many antibiotic reactions documented as allergies were unknown or not remembered by the patient, cutaneous reactions unrelated to drug hypersensitivity, drug-infection interactions, or drug intolerances. Although such reactions pose negligible risk to patients (...) , they currently represent a global threat to public health. Antibiotic allergy labels result in displacement of first-line therapies for antibiotic prophylaxis and treatment. A penicillin allergy label, in particular, is associated with increased use of broad-spectrum and non-β-lactam antibiotics, which results in increased adverse events and antibiotic resistance. Most patients labelled as allergic to penicillins are not allergic when appropriately stratified for risk, tested, and re-challenged. Given

2018 Lancet

89. Triple Antibiotic Solution Promotes Similar Antibacterial Effects as Calcium Hydroxide/2% Chlorhexidine When Used as an Intracanal Medicament

instrumentation and/or irrigation, are effective in canal disinfection. The intracanal antimicrobial efficacy of triple antibiotic formulation is shown to be superior to calcium hydroxide alone, or at least comparable to calcium hydroxide combined with 2% chlorhexidine when assessing antibacterial efficacy and clinical outcomes. Perspective: Randomized clinical trials are currently the highest available evidence comparing use of triple antibiotic paste against other canal medicaments in primary teeth (...) Triple Antibiotic Solution Promotes Similar Antibacterial Effects as Calcium Hydroxide/2% Chlorhexidine When Used as an Intracanal Medicament UTCAT3361, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Triple Antibiotic Solution Promotes Similar Antibacterial Effects as Calcium Hydroxide/2% Chlorhexidine When Used as an Intracanal Medicament Clinical Question In patients undergoing non-surgical therapy in a tooth

2018 UTHSCSA Dental School CAT Library

90. Chronic obstructive pulmonary disease (acute exacerbation): antimicrobial prescribing

implications 24 Chronic obstructive pulmonary disease (acute exacerbation): antimicrobial prescribing (NG114) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 24This guideline should be read in conjunction with NG115. Ov Overview erview This guideline sets out an antimicrobial prescribing strategy for acute exacerbations of chronic obstructive pulmonary disease (COPD). It aims to optimise antibiotic use and reduce (...) antibiotic resistance. See a 2-page visual summary of the recommendations, including tables to support prescribing decisions. See the NICE guideline on COPD in over 16s for other recommendations on preventing and managing an acute exacerbation of COPD, including self-management. Who is it for? Health professionals People with COPD, their families and carers Chronic obstructive pulmonary disease (acute exacerbation): antimicrobial prescribing (NG114) © NICE 2019. All rights reserved. Subject to Notice

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

91. 2018 IDSA Clinical Practice Guideline for the Management of Outpatient Parenteral Antimicrobial Therapy

to either remain in hospital for IV antibiotic therapy or forgo IV antimicrobial treatment [42–45]. Methodology Panel Composition The last version of the IDSA OPAT Guideline was published in 2004 [1]. For the current update, 1 of the chairs assembled 11 ID physicians from both academic and private practice settings, including 3 pediatric ID physicians who are members of the Pediatric Infectious Diseases Society. Also included were an experienced ID pharmacist, a member of the Infusion Nursing Society (...) to SNFs, sending patients home without a VAD but bringing them to an outpatient facility for each antimicrobial administration, or keeping them in hospital for the duration of their parenteral antibiotic treatment course. It should be noted that there are no data to suggest that the risk of device misuse is any lower in SNFs, where patients have ample opportunity for illicit drug administration. Confirmation about whether PWID are at higher risk of vascular access complications during OPAT and, if so

2018 Infectious Diseases Society of America

92. Advances in optimizing the prescription of antibiotics in outpatient settings. Full Text available with Trip Pro

Advances in optimizing the prescription of antibiotics in outpatient settings. The inappropriate use of antibiotics can increase the likelihood of antibiotic resistance and adverse events. In the United States, nearly a third of antibiotic prescriptions in outpatient settings are unnecessary, and the selection of antibiotics and duration of treatment are also often inappropriate. Evidence shows that antibiotic prescribing is influenced by psychosocial factors, including lack of accountability (...) , perceived patient expectations, clinician workload, and habit. A varied and growing body of evidence, including meta-analyses and randomized controlled trials, has evaluated interventions to optimize the use of antibiotics. Interventions informed by behavioral science-such as communication skills training, audit and feedback with peer comparison, public commitment posters, and accountable justification-have been associated with improved antibiotic prescribing. In addition, delayed prescribing, active

2018 BMJ

93. The endogenous antimicrobial cathelicidin LL37 induces platelet activation and augments thrombus formation Full Text available with Trip Pro

The endogenous antimicrobial cathelicidin LL37 induces platelet activation and augments thrombus formation Platelet-associated complications including thrombosis, thrombocytopenia, and hemorrhage are commonly observed during various inflammatory diseases such as sepsis, inflammatory bowel disease, and psoriasis. Despite the reported evidence on numerous mechanisms/molecules that may contribute to the dysfunction of platelets, the primary mechanisms that underpin platelet-associated (...) complications during inflammatory diseases are not fully established. Here, we report the discovery of formyl peptide receptor 2, FPR2/ALX, in platelets and its primary role in the development of platelet-associated complications via ligation with its ligand, LL37. LL37 acts as a powerful endogenous antimicrobial peptide, but it also regulates innate immune responses. We demonstrate the impact of LL37 in the modulation of platelet reactivity, hemostasis, and thrombosis. LL37 activates a range of platelet

2018 Blood advances

94. A review of antibiotic prophylaxis for traveler’s diarrhea: past to present Full Text available with Trip Pro

A review of antibiotic prophylaxis for traveler’s diarrhea: past to present As there is rapid increase in international travel to tropical and subtropical countries, there will likely be more people exposed to diarrheal pathogens in these moderate to high risk areas and subsequent increased concern for traveler's diarrhea. The disease may appear as a mild clinical syndrome, yet a more debilitating presentation can lead to itinerary changes and hospitalization. As bacterial etiologies (...) are the most common causative agents of TD, the use of antibiotic prophylaxis to prevent TD has been reported among travelers for several years. The most common type of antibiotic used for TD has changed over 50 years, depending on many influencing factors. The use of antibiotic prophylaxis for TD prevention in travelers is still controversial, mainly because of difficulties balancing the risks and benefits. Many factors, such as emerging drug resistance, side effects, cost and risk behavior need

2018 Tropical diseases, travel medicine and vaccines

95. Hospital-based antibiotic use in patients with Mycobacterium avium complex Full Text available with Trip Pro

Hospital-based antibiotic use in patients with Mycobacterium avium complex Treatment guidelines exist for pulmonary Mycobacterium avium complex (MAC) infection, although studies suggest poor concordance in clinician practice. Using a national database including hospital encounters of laboratory-confirmed MAC patients, we sought to characterise US treatment practices. We assessed patients in the Premier Healthcare Database from 2009 to 2013 with two or more MAC-positive cultures or one MAC (...) % resistance-associated therapy. Patients were more likely to receive guidelines-based therapy if they had multiple hospital encounters (aRR 1.5), codes for PNTM (aRR 5.7) or tuberculosis (aRR 4.5) or radiological procedures (aRR 10.9); multiple hospital encounters (aRR 0.8) or a tuberculosis code (aRR 0.1) were less likely to be associated with receiving resistance-promoting regimens. In hospital-based MAC patients, half received antibiotics active against MAC, a low proportion received therapy based

2018 ERJ open research

96. Is Antibiotic Therapy Helpful for Preventing Infection After Acute Stroke? (SRS therapy)

Is Antibiotic Therapy Helpful for Preventing Infection After Acute Stroke? (SRS therapy) Is Antibiotic Therapy Helpful for Preventing Infection After Acute Stroke? TAKE-HOME MESSAGE In patients with acute ischemic or hemorrhagic stroke, prophylactic antibiotics reduce the overall infection rate, but do not reduce the risk of pneumonia, death or dependency. EBEM Commentators Latha Ganti, MD, MBA Department of Clinical Sciences University of Central Florida College of Medicine Orlando, FL Bryan (...) Sleigh, MD Department of Emergency Medicine Mercer University School of Medicine Macon, GA Jestin N. Carlson, MD, MS, and Alan Jones, MD, serve as editors of the SRS series. Editor’s Note: This is a clinical synopsis, a regular feature of the Annals’ Systematic Review Snapshot (SRS) series. The source for this systematic review snapshot is: Vermeij JD, Westendorp WF, Dippel DWJ, et al. Antibiotic therapy for preventing infections in people with acute stroke. Cochrane Database Syst Rev. 2018;1

2018 Annals of Emergency Medicine Systematic Review Snapshots

97. Systemic Antibiotics for the Treatment of Skin and Soft Tissue Abscesses: A Systematic Review and Meta-Analysis

Systemic Antibiotics for the Treatment of Skin and Soft Tissue Abscesses: A Systematic Review and Meta-Analysis Systemic Antibiotics for the Treatment of Skin and Soft Tissue Abscesses: A Systematic Review and Meta-Analysis Michael Gottlieb, MD*; Joshua M. DeMott, PharmD, MSc; Marilyn Hallock, MD, MS; Gary D. Peksa, PharmD *Corresponding Author. E-mail: michaelgottliebmd@gmail.com, Twitter: @MGottliebMD. Study objective: The addition of antibiotics to standard incision and drainage (...) is controversial, with earlier studies demonstrating no signi?cant bene?t. However, 2 large, multicenter trials have recently been published that have challenged the previous literature. The goal of this review was to determine whether systemic antibiotics for abscesses after incision and drainage improve cure rates. Methods: PubMed, the Cumulative Index of Nursing and Allied Health Literature, Scopus, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials

2018 Annals of Emergency Medicine Systematic Review Snapshots

98. 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

99. Prostatitis (acute): antimicrobial prescribing

is it for? 4 Recommendations 5 1.1 Managing acute prostatitis 5 1.2 Self-care 6 1.3 Choice of antibiotic 7 Summary of the evidence 9 Self-care 9 Antibiotics 9 Choice of antibiotic 11 Antibiotic course length 14 Antibiotic prophylaxis for preventing infective complications, including acute prostatitis, after biopsy 16 Other considerations 17 Medicines adherence 17 Resource implications 17 Prostatitis (acute): antimicrobial prescribing (NG110) © NICE 2019. All rights reserved. Subject to Notice of rights (...) (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 17Ov Overview erview This guideline sets out an antimicrobial prescribing strategy for acute prostatitis. 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

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

100. Pyelonephritis (acute): antimicrobial prescribing

is it for? 4 Recommendations 5 1.1 Managing acute pyelonephritis 5 1.2 Self-care 7 1.3 Choice of antibiotic 7 Summary of the evidence 13 Self-care 13 Antibiotics 13 Choice of antibiotic 14 Antibiotic course length 21 Antibiotic dose frequency 23 Antibiotic route of administration 23 Other considerations 25 Medicines adherence 25 Resource implications 25 Pyelonephritis (acute): antimicrobial prescribing (NG111) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms (...) -and- conditions#notice-of-rights). Page 3 of 26This guideline should be read in conjunction with NG109, NG112 and CG54. Ov Overview erview This guideline sets out an antimicrobial prescribing strategy for acute pyelonephritis (upper urinary tract infection) 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 a table to support prescribing decisions. NICE has also

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines