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Azithromycin for the secondary prevention of coronary artery disease: a meta-analysis

The authors’ cautious conclusion that azithromycin does not appear to reduce the frequency or occurrence of cardiac events in patients with coronary artery disease appears to reflect the results reported. However, it is possible that relevant studies might have been missed.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

Effects of prolonged use of azithromycin in patients with cystic fibrosis: a meta-analysis

This review found that azithromycin improved lung function in patients with cystic fibrosis, especially those colonised by Pseudomonas. Nausea and diarrhoea were more frequent with azithromycin. The small number of studies, possibility of missed studies and lack of details of the review process made the reliability of the authors' conclusions unclear.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Azithromycin-containing versus standard triple therapy for Helicobacter pylori eradication: a meta-analysis

The review concluded that azithromycin-containing triple therapy for first-line Helicobacter pylori eradication was equally effective to standard triple eradication therapy and had a lower occurrence of side effects. In view of some potential limitations arising from the review process, and the overall average quality of included trials, the extent to which the authors’ conclusions are reliable is unclear.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Minimal Modeling Approaches to Value of Information Analysis for Health Research [Internet]

Value of information (VOI) techniques can provide estimates of the expected benefits from clinical research studies. These VOI estimates can inform decisions about the design and priority of those studies. Most VOI studies use decision analytic models to characterize the uncertainty of the effects of interventions on health outcomes. For some potential applications of VOI, the complexity of constructing such models poses barriers to practical application of VOI. However, because some clinical studies can directly characterize uncertainty in health outcomes, it may sometimes be possible to perform VOI analysis with only minimal modeling. This paper (1) develops a framework to define and classify minimal modeling approaches to VOI; (2) reviews existing VOI studies that apply minimal modeling approaches; and (3) illustrates and discusses the application of the minimal modeling to two new clinical applications to which the approach appears well suited because clinical trials with comprehensive outcomes provide preliminary estimates of the uncertainty in outcomes. We conclude that minimal modeling approaches to VOI can be readily applied to in some instances to develop estimates of the expected benefits of clinical research.

Methods Future Research Needs Reports - Agency for Healthcare Research and Quality (US).

Version: June 2011
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Effectiveness and safety of macrolides in cystic fibrosis patients: a meta-analysis and systematic review

OBJECTIVES: To evaluate the efficacy and safety of macrolides in cystic fibrosis (CF).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Preventing COPD exacerbations with macrolides: a review and budget impact analysis

Long-term treatment with macrolides has recently been shown to reduce COPD exacerbations in doses lower than bactericidal doses. This article aims to critically review the international literature relating to the long-term effectiveness and safety of macrolides and to estimate the budget impact of preventing exacerbations with azithromycin in Belgium. Controlled clinical studies focusing on the prevention of COPD exacerbations with long-term macrolide treatment were identified in PubMed, EMBASE, Controlled Trials Registry of the Cochrane Library, and Social Science and Citation Index. The budget impact of preventing exacerbations with azithromycin in Belgium over a one-year period was calculated as the difference between the additional expenditure of annual treatment with azithromycin and the savings in hospital expenditure arising from fewer COPD exacerbations in patients with GOLD stages II-IV. Prevalence and resource use data were derived from the literature and unit cost data from Belgian sources. The literature review suggests that long-term treatment of COPD patients with azithromycin, erythromycin or clarithromycin is effective and safe, and reduces exacerbations and related hospitalizations. However, uncertainty remains about the specific patient population that is most likely to benefit from long-term macrolide treatment, the optimal dose and duration of macrolide treatment, and the potential impact of long-term macrolide treatment on resistance. The budget impact analysis demonstrated that annual hospital savings of €950 million resulting from fewer exacerbations outweighed additional expenditure on azithromycin of €595 million, implying that the prevention of COPD exacerbations with azithromycin is a cost saving strategy in Belgium.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Meta-analysis of drug treatment for scrub typhus in Asia

OBJECTIVE: Scrub typhus is an important febrile disease in Asia, and antibiotics have been used to treat this disease. The purpose of this study was to generate large-scale evidence of the efficacy of different antibiotic regimens for treating scrub typhus using a meta-analysis.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

The added value of water, sanitation, and hygiene interventions to mass drug administration for reducing the prevalence of trachoma: a systematic review examining

Trachoma is the leading cause of infectious blindness worldwide. The SAFE strategy, the World Health Organization-recommended method to eliminate blinding trachoma, combines developments in water, sanitation, surgery, and antibiotic treatment. Current literature does not focus on the comprehensive effect these components have on one another. The present systematic review analyzes the added benefit of water, sanitation, and hygiene education interventions to preventive mass drug administration of azithromycin for trachoma. Trials were identified from the PubMed database using a series of search terms. Three studies met the complete criteria for inclusion. Though all studies found a significant change in reduction of active trachoma prevalence, the research is still too limited to suggest the impact of the "F" and "E" components on trachoma prevalence and ultimately its effects on blindness.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Ivacaftor (Kalydeco) 150 mg Tablet: For Treatment of Cystic Fibrosis with G551D, G1244E, G1349D, G178R, G551S, S1251N, S1255P, S549N, S549R, or G970R Mutation [Internet]

Cystic fibrosis (CF), an autosomal recessive condition, is the most common fatal genetic disease affecting children and young adults in Canada. It is caused by mutations in the CF transmembrane conductance regulator (CFTR) gene, located on chromosome seven. This gene encodes for a chloride channel that regulates transport of salt and water across cell membranes. When CFTR is dysfunctional, secretions become tenacious and sticky, resulting in pathology in multiple organ systems, most notably the lungs and gastrointestinal tract.

Common Drug Review - Canadian Agency for Drugs and Technologies in Health.

Version: July 2015
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Efficacy of short course (<4 days) of antibiotics for treatment of acute otitis media in children: a systematic review of randomized controlled trials

This review found no evidence of increased risk of treatment failure with short-course (<4 days) compared with long-course (≥4 days) antibiotics for acute otitis media in children. The authors' conclusions are likely to be reliable, but should be interpreted with some caution due to a lack of detail on searches, quality assessment and individual study features.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Management of Acute Otitis Media: Update

Acute Otitis Media (AOM), a viral or bacterial infection of the ear, is the most common childhood infection for which antibiotics are prescribed in the United States. In 2001, the Southern California Evidence-based Practice Center conducted a systematic review of the evidence comparing treatments of AOM.

Evidence Reports/Technology Assessments - Agency for Healthcare Research and Quality (US).

Version: November 2010
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Long-acting Reversible Contraception: The Effective and Appropriate Use of Long-Acting Reversible Contraception

Contraception can be divided into two broad categories: hormonal and nonhormonal. There are two categories of hormonal contraception: combined oestrogen and progestogen and progestogen-only. Long-acting reversible contraception (LARC) is defined in this guideline as methods that require administering less than once per cycle or month.

NICE Clinical Guidelines - National Collaborating Centre for Women’s and Children’s Health (UK).

Version: October 2005
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Interventions for the prevention of mycobacterium avium complex in adults and children with HIV

Mycobacterium avium complex (MAC) infection is a common complication of advanced acquired immunodeficiency syndrome (AIDS) disease and can shorten the survival of these patients. We sought to examine effectiveness of all drugs for preventing MAC infection in adults and children with HIV infection. This review included eight trials conducted in the USA and Europe, published between 1993 and 2003.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Interventions for treating genital chlamydia trachomatis infection in pregnancy

Chlamydia is a sexually transmitted infection which, if a mother has it during pregnancy and labour, can cause eye or lung infections in the newborn baby. The risk of transmission during birth varies, but is about 20% to 50% for eye infections and about 10% to 20% for infection of the lungs. Mothers may also be at increased risk of infection of the uterus. The review looked at various antibiotics being used during pregnancy to reduce these problems and to assess any adverse effects. Tetracyclines taken in pregnancy are known to be associated with teeth and bone abnormalities in babies, and some women find erythromycin unpleasant to take because of feeling sick and vomiting. The review found eleven trials, involving 1449 women, on erythromycin, amoxycillin, azithromycin and clindamycin, and the overall trial quality was good. However, all the trials assessed 'microbiological cure' (that is they looked for an eradication of the infection) and none assessed whether the eye or lung problems for the baby were reduced. Also, none of the trials were large enough to assess potential adverse outcomes adequately. The review found amoxycillin was an effective alternative to erythromycin but lack of long‐term assessment of outcomes caused concern about its routine use in practice. If erythromycin is used, some women may stop taking it because of adverse effects. Azithromycin and clindamycin are potential alternatives. More research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Antibiotics for treating scrub typhus

Scrub typhus is transmitted by chiggers (mites), is a bacterial infection and causes fever and a typical sore on the skin, and is common in the western Pacific region and many parts of Asia, particularly in agricultural workers and travellers in areas where the disease is common, particularly people camping, rafting, or trekking . This review summarize the information from seven small trials about the effects of antibiotics on scrub typhus. Most of the antibiotics tested worked: this includes: doxycycline, tetracycline, telithromycin and azithromycin. Rifampicin seem to be more effective than doxycycline in areas where scrub typhus appears to respond poorly to standard anti‐rickettsial drugs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Antibiotics for bronchiolitis in children under two years of age

We reviewed the evidence on the effect of antibiotics on clinical outcomes in children with bronchiolitis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Interventions to treat chronic infection of the prostate gland (chronic bacterial prostatitis)

Chronic bacterial prostatitis (CBP) involves infection and inflammation of the prostate gland in men of all ages. It can cause problems urinating, including discomfort and pain, increased frequency and urge, or problems emptying the bladder. Bacteria infecting the prostate are the cause of CBP. These bacteria may be sexually transmitted. To cure CBP, antibiotics must be administered for extended periods of time (four weeks or longer), but a permanent cure is not always guaranteed. Other drugs may be combined with antibiotics to improve CBP symptoms. This review found that fluoroquinolones like ciprofloxacin, levofloxacin, lomefloxacin, ofloxacin or prulifloxacin have equivalent effects and equivalent success rates in CBP patients. If atypical bacteria like chlamydia are suspected to cause CBP, macrolide antibiotics such as azithromycin may achieve better results compared to the fluoroquinolone ciprofloxacin. It must be taken into account that some of the studies that have been performed are of poor quality or have been performed on small numbers of participants. More studies are needed, focusing on new agents or on optimized doses of currently prescribed antibiotics.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Antibiotics for prevention with IUDs

An intrauterine device (IUD) is a small device placed in the womb for long‐term birth control. Many people worry about the woman getting pelvic inflammatory disease (PID) with an IUD. This infection can lead to problems in getting pregnant. If PID occurs, it is often within the first few weeks. Antibiotics are sometimes used before inserting an IUD to prevent an infection. This review looked at how well these preventive drugs reduced problems. Such problems include PID, extra health care visits, and stopping IUD use in three months.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Fluoroquinolones for treating enteric fever

Researchers in The Cochrane Collaboration conducted a review of the effect of fluoroquinolone antibiotics in people enteric fever. After searching for relevant studies, they identified 26 studies involving 3033 patients. Their findings are summarized below.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Interventions for trachomatous trichiasis

Trachoma is the commonest infectious cause of blindness in the world. It is caused by a bacterium called Chlamydia trachomatis. This infection causes inflammation and scarring of the surface of the eye, which results in the eyelid turning in (entropion) so that the eyelashes touch the eyeball. This is known as trachomatous trichiasis. The lashes can scratch the corneal surface, leading directly or indirectly (from secondary infections) to corneal opacity. Surgery to correct the eyelid deformity is the main treatment for the late stages of the disease. Most cases of trachomatous trichiasis occur in sub‐Saharan Africa. They are generally treated by nurses with limited surgical training. Unfortunately the results of the surgery can be quite variable, with frequent post‐operative trichiasis reported. Therefore, we wanted to find out what types of surgery and other interventions give the best results in treating this condition.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Systematic Reviews in PubMed

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Systematic Review Methods in PubMed

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