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

1381. Antibiotic elimination of group-B streptococci in urine in prevention of preterm labour. (Abstract)

Antibiotic elimination of group-B streptococci in urine in prevention of preterm labour. The presence of group-B streptococci in the urine of pregnant women seems to be associated with preterm labour. Urine samples from 4122 women at 27-31 weeks' gestation were examined for bacteria. Group-B streptococci were found in the urine of 69 women. In a double-blind, controlled study these patients were given either penicillin (10(6) IU three times daily for 6 days; 37 patients) or placebo (32 patients

1987 Lancet Controlled trial quality: uncertain

1382. Antibiotic administration to treat possible occult bacteremia in febrile children. (Abstract)

Antibiotic administration to treat possible occult bacteremia in febrile children. We performed a prospective, randomized, placebo-controlled, double-blind clinical trial of antibiotic administration to treat possible occult bacteremia in febrile children. A total of 955 children aged 3 to 36 months with temperatures greater than or equal to 39.0 degrees C and no focal bacterial infection were enrolled at the emergency departments of two children's hospitals from January 1982 until July 1984 (...) infectious morbidity associated with bacteremia between the antibiotic and placebo groups--2 of 19 patients (10.5 percent) in the antibiotic group and 1 of 8 (12.5 percent) in the placebo group--although the power for this comparison was low. Antibiotics reduced fever (P less than 0.005) and improved the clinical appearance (P = 0.07) in the children with bacteremia but not in those without bacteremia. Although there were no statistically significant differences in the incidence of side effects, diarrhea

1987 NEJM Controlled trial quality: predicted high

1383. Ceftazidime combined with a short or long course of amikacin for empirical therapy of gram-negative bacteremia in cancer patients with granulocytopenia. The EORTC International Antimicrobial Therapy Cooperative Group. (Abstract)

Ceftazidime combined with a short or long course of amikacin for empirical therapy of gram-negative bacteremia in cancer patients with granulocytopenia. The EORTC International Antimicrobial Therapy Cooperative Group. To determine whether combination antibiotic therapy including a short course of an aminoglycoside was as effective and less toxic than a conventional long course of the combination for the empirical therapy of gram-negative bacteremia in patients with cancer and granulocytopenia (...) , we conducted a randomized multicenter trial comparing ceftazidime plus a short course (three days) of amikacin, ceftazidime plus a long course (nine days) of amikacin, and azlocillin plus a long course (nine days) of amikacin. Single-organism gram-negative bacteremia occurred in 129 of 872 evaluable patients. Without a change in antibiotics, the response rates were 81 percent with ceftazidime and long-course amikacin, 48 percent with ceftazidime and short-course amikacin (P = 0.002), and 40

1987 NEJM Controlled trial quality: uncertain

1384. Staphylococcus aureus nasal carriage and infection in patients on hemodialysis. Efficacy of antibiotic prophylaxis. (Abstract)

Staphylococcus aureus nasal carriage and infection in patients on hemodialysis. Efficacy of antibiotic prophylaxis. We conducted a five-year prospective controlled study of prophylaxis of Staphylococcus aureus nasal carriage and infection among patients in a hemodialysis unit. Carriers tended to have chronic colonization with a single phage type. S. aureus infections occurred significantly more frequently in carriers than in noncarriers and, in 93 percent of the infected carriers, were caused

1986 NEJM Controlled trial quality: uncertain

1385. A randomized trial comparing ceftazidime alone with combination antibiotic therapy in cancer patients with fever and neutropenia. (Abstract)

percent were alive at 72 hours and 89 percent when the neutropenia resolved, as compared with 98 percent and 91 percent, respectively, of those given combination therapy. The majority of episodes of documented infection in both treatment groups necessitated additional antimicrobial treatment or other modifications of the initial regimen, as compared with only 22 percent of the episodes of unexplained fever. We conclude that initial single-agent therapy with certain beta-lactam antibiotics is a safe (...) A randomized trial comparing ceftazidime alone with combination antibiotic therapy in cancer patients with fever and neutropenia. To assess the efficacy of single-agent therapy relative to standard combination antibiotic therapy for the initial management of fever and neutropenia in cancer patients, we conducted a randomized trial comparing ceftazidime alone with a combination of cephalothin, gentamicin, and carbenicillin. Of 550 evaluable episodes of fever and neutropenia, 282 were treated

1986 NEJM Controlled trial quality: uncertain

1386. Relative importance of antibiotic and improved clearance in topical treatment of chronic mucopurulent rhinosinusitis. A controlled study. (Abstract)

Relative importance of antibiotic and improved clearance in topical treatment of chronic mucopurulent rhinosinusitis. A controlled study. 50 patients with chronic mucopurulent rhinosinusitis were randomly allocated to treatment with nasal sprays of dexamethasone, tramazoline, and neomycin, dexamethasone and tramazoline with no antibiotic, or matched placebo (propellant alone) four times daily to both nostrils for 2 weeks. The patients were assessed in a double-blind manner for symptomatic (...) response and improvement in nasal mucociliary clearance, nasal airway resistance, sinus radiographs, and intranasal bacteriology and appearance. Both active preparations (with antibiotic 14 of 20 patients responded; without antibiotic 12 of 20 patients responded) were more effective than the placebo (2 of 10 patients responded). There was no significant difference in response between the active preparations with and without antibiotic. Thus, in treatment of chronic mucopurulent rhinosinusitis

1986 Lancet Controlled trial quality: uncertain

1387. A scoring method (ASEPSIS) for postoperative wound infections for use in clinical trials of antibiotic prophylaxis. (Abstract)

A scoring method (ASEPSIS) for postoperative wound infections for use in clinical trials of antibiotic prophylaxis. To compare antibiotic regimens for their effectiveness in preventing or treating wound sepsis, well-defined criteria for outcome are needed. A method of assessing wound healing has been devised that defines carefully the characteristics to be considered and how they are to be awarded points. Objective criteria are also included in the assessment. Points are given for the need

1986 Lancet

1388. Persistence of improvement in antibiotic prescribing in office practice. (Abstract)

Persistence of improvement in antibiotic prescribing in office practice. We evaluated persistence of the prescribing improvement seen in a previous statewide controlled trial, which measured improvement in the prescribing of contraindicated antibiotics and oral cephalosporins in the year after an educational intervention. Doctors visited by physician-counselors substantially improved their prescribing of both classes of drugs. The beneficial effect of the physician-counselors persisted

1985 JAMA

1389. Benefit-cost analysis of antimicrobial prophylaxis in abdominal and vaginal hysterectomy. (Abstract)

Benefit-cost analysis of antimicrobial prophylaxis in abdominal and vaginal hysterectomy. We performed a benefit-cost analysis of antimicrobial prophylaxis for hysterectomy using data from a randomized, placebo-controlled clinical trial of the efficacy of three doses of cefazolin sodium. The excess cost per patient with either operative site or urinary tract infection, or febrile morbidity diagnosed during hospitalization, was +1,777 for vaginal and +716 for abdominal hysterectomy. In patients

1983 JAMA

1390. Double-blind study to compare the selection of antibiotic resistance by amoxycillin or cephradine in the commensal flora. (Abstract)

Double-blind study to compare the selection of antibiotic resistance by amoxycillin or cephradine in the commensal flora. Elderly patients with acute urinary infections were treated in a double-blind study with either amoxycillin or cephradine. In 52 patients who had received amoxycillin for one week about a third of all intestinal Escherichia coli were highly resistant to amoxycillin, and many were resistant to tetracycline, trimethoprim, or chloramphenicol. Cephradine selected less resistance (...) . At a week after completion of chemotherapy, cephradine-resistant E coli were replaced by sensitive cultures at a greater frequency than were amoxycillin-resistant E coli. Neither antibiotic altered the skin flora. Amoxycillin, but not cephradine, selected for Enterobacteriaceae in the saliva. The propensity of amoxycillin to select resistance in E coli will limit its usefulness in treating urinary infections.

1983 Lancet Controlled trial quality: uncertain

1391. Improving antibiotic prescribing in office practice. A controlled trial of three educational methods. (Abstract)

Improving antibiotic prescribing in office practice. A controlled trial of three educational methods. We conducted a statewide controlled trial of three methods to improve antibiotic prescribing in office practice: a mailed brochure, a drug educator visit, and a physician visit. Educational topics were three antibiotics contraindicated for office practice and oral cephalosporins. Medicaid prescribing data were used to select donors who needed education. The effect of the methods was evaluated (...) by comparing the change in prescribing (the year before the intervention v the year after the intervention) for the doctors receiving education with the prescribing of comparable doctors chosen as controls. The mailed brochure had no detectable effect, and the drug educator had only a modest effect. The physician visits produced strong attributable reductions in prescribing of both drug classes. For the contraindicated antibiotics, the reductions were 18% in number of doctors prescribing, 44% in number

1983 JAMA

1392. Routine antibiotics in hospital management of acute asthma. (Abstract)

Routine antibiotics in hospital management of acute asthma. The value of antibiotics was assessed in a randomised, double-blind study of amoxycillin and placebo in sixty adults admitted to hospital with acute exacerbations of asthma. 37 exacerbations were treated with amoxycillin and 34 were treated with placebo. Response to treatment was closely monitored but no significant difference in improvement was demonstrated between groups for length of hospital stay, time taken for 50% improvement (...) in symptoms, patient's self assessment and respiratory function, and symptoms and respiratory function at time of discharge from hospital. Antibiotics should not be given routinely to patients admitted to hospital with acute exacerbations of asthma.

1982 Lancet Controlled trial quality: uncertain

1393. Therapy of acute otitis media: myringotomy, antibiotics, or neither? A double-blind study in children. (Abstract)

Therapy of acute otitis media: myringotomy, antibiotics, or neither? A double-blind study in children. In a double-blind study 171 children with acute otitis media (239 affected ears) were treated by four different methods: neither antibiotics nor myringotomy; myringotomy only; antibiotics only; or both antibiotics and myringotomy. All received symptomatic treatment. There were no significant differences in clinical course (pain, temperature, duration of discharge, otoscopic appearances (...) , audiography, recurrence rate) between the four groups. In the groups treated without antibiotics, the ears discharge for slightly longer and the eardrums took a little longer to heal; these differences were not significant. No complications were seen. Symptomatic therapy with nosedrops and analgesics seems a reasonable initial approach to acute otitis media in children. Myringotomy and antibiotics can be reserved for cases in which the course of otitis is irregular, there are complications

1981 Lancet Controlled trial quality: uncertain

1394. Prophylactic antibiotics in simple hand lacerations. (Abstract)

Prophylactic antibiotics in simple hand lacerations. A randomized prospective study of 265 patients with hand lacerations was carried out to define the role of prophylactic antibiotics in the management of simple, sutured wounds of the hand. Two hundred sixty-five patients were followed up until suture removal or satisfactory wound healing. There were a total of three infections (1.1%). There was no noticeable differences in the incidence of infection in the antibiotic and placebo treatment (...) groups. It is concluded that prophylactic antibiotics are an unnecessary adjunct in the treatment of simple lacerations of the hand and no replacement for meticulous wound management.

1981 JAMA Controlled trial quality: uncertain

1395. Antimicrobial vs placebo prophylaxis in noncardiac thoracic surgery. (Abstract)

Antimicrobial vs placebo prophylaxis in noncardiac thoracic surgery. A prospective, double-blind evaluation of the efficacy and safety of prophylactic cephalosporins was done in 57 patients undergoing noncardiac thoracic surgery. Twenty-eight received cephalosporin therapy, and 29 received placebo. Overall, the incidence of postoperative infections was the same; infections developed in five (17.8%) of the 28 patients in the cephalosporin group and in five (17.2%) of the 29 patients

1979 JAMA Controlled trial quality: uncertain

1396. Comparison between systemic and oral antimicrobial prophylaxis in colorectal surgery. (Abstract)

antimicrobials orally were due to kanamycin-resistant bacteria present in the colon at operation. Bacterial overgrowth of Staphylococcus aureus was recorded in 6 of the patients who received oral therapy. Antibiotic-associated pseudomembranous colitis occurred in 7 patients, 6 of whom had received prophylaxis orally. These results indicate that oral administration of prophylactic antimicrobials in colon surgery should be avoided because of the risks of bacterial resistance, superinfection, and antibiotic (...) Comparison between systemic and oral antimicrobial prophylaxis in colorectal surgery. In a prospective randomised trial in which 93 patients undergoing elective colorectal operations were given a short prophylactic course of metronidazole and kanamycin orally or systemically, postoperative sepsis occurred in only 3 (6.5%) of those given antimicrobials systemically, compared with 17 (36%) of those given oral prophylaxis (P less than 0.01). 15 of the 17 infections in patients who received

1979 Lancet

1397. Antibiotic irrigation and catheter-associated urinary-tract infections. (Abstract)

Antibiotic irrigation and catheter-associated urinary-tract infections. To investigate the efficacy of antibiotic irrigation in preventing catheter-associated urinarytract infection, we carried out a randomized controlled trial of a neomycin-polymyxin irrigant administered through closed urinary catheters. Eighteen of 98 (18 per cent) of the patients not given irrigation became infected, as compared with 14 of 89 (16 per cent) of those given irrigation, yielding a mean daily incidence of 5 per (...) cent in each group. The distribution of organisms and their antibiotic sensitivities differed in the two groups, the organisms from the patients with irrigation being more resistant. Disconnections of the catheter junctions were associated with high rates of infection. The rate of disconnections of the junctions in the group given irrigation was almost twice that of the control group because of the presence of the extra junction on overall infection rate represents the result of two opposing

1978 NEJM Controlled trial quality: uncertain

1398. Prophylactic systemic antibiotics in colorectal surgery. (Abstract)

Prophylactic systemic antibiotics in colorectal surgery. The prophylactic value of gentamicin combined with either lincomycin or metronidazole in 52 patients undergoing colorectal surgery was investigated. The results confirmed the value of this practice. In a control group, the sepsis-rate was 48% with 1 death attributable to sepsis, compared with a sepsis-rate of 4% in the treated group. The combination of gentamicin and lincomycin was effective against sepsis but pseudomembranous colitis

1977 Lancet Controlled trial quality: uncertain

1399. Oral non-absorbed antibiotics prevent infection in acute non-lymphoblastic leukaemia. (Abstract)

Oral non-absorbed antibiotics prevent infection in acute non-lymphoblastic leukaemia. 113 patients being treated for acute non-lymphoblastic leukaemia were investigated to determine the effect of suppression of body microbial flora on prevention of infection. They were randomly allocated to a control group or a group which received non-absorbed antibiotics by mouth and topical applications of cutaneous and mucosal antiseptic preparations. The group receiving oral non-absorbed antibiotics had (...) significantly few infections, fewer deaths from infection, fewer pyrexial episodes, and consequently received less systemic antibiotic therapy than the controls.

1977 Lancet

1400. Prevention of wound infection in abdominal operations by peroperative antibiotics or povidone-iodine. A controlled trial. (Abstract)

Prevention of wound infection in abdominal operations by peroperative antibiotics or povidone-iodine. A controlled trial. The wound-infection rate after abdominal operations was compared in 113 patients randomly allocated to an untreated control group, a group receiving preoperative lincomycin and tobramycin, or a group receiving local instillation of povidone-iodine. The wound-infection rate was 8.1% in 37 patients receiving antibiotics, 42.1% in 38 untreated controls, and 39.5% in 38 patients

1977 Lancet Controlled trial quality: uncertain